Care Mgmt / Counsel · CMS status A

99439

Chrnc care mgmt staf ea addl

Chronic care management, each additional 20 minutes of clinical staff time directed by a physician or QHP per calendar month. CMS 2026 wRVU 0.70, paid using the national GPCI and the 2026 conversion factor of $33.4009. Add-on to 99490, maximum 2 units per month.

Work RVU
0.70
2026 Medicare pays
$50.44
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 0.70 + Practice 0.76 + Malpractice 0.05 = 1.51 total
Work (your effort)Practice expenseMalpractice

When to use it

Use 99439 when documented clinical staff CCM time for the month exceeds the 20 minutes covered by 99490. The first unit applies at 40 cumulative minutes, the second at 60; two units is the monthly ceiling, so staff-time CCM tops out at 60 billable minutes (99490 + 2 x 99439).

Full guidance

The patients who routinely reach add-on territory are the ones with active care plans in motion: a heart failure patient with weekly diuretic titration calls, a poorly controlled diabetic getting structured glucose-log review and coaching, a frail elder whose care involves repeated coordination with home health, pharmacy, and family. Time counts when clinical staff (MA, LPN, RN, care manager) perform care plan activities under the billing clinician's general supervision: phone calls, medication reconciliation, coordinating referrals and DME, arranging community services, reviewing remote data, and documenting against the care plan. If the billing clinician personally performs the work instead, use the 99491/99437 track; the staff and clinician code families cannot be mixed for the same patient in the same month.

Documentation checklist

Common pitfalls

Common ICD-10 pairings
E11.9I10N18.3I50.32J44.9M81.0

Payer notes

Medicare and Medicare Advantage cover 99439 with the same patient cost share as 99490; consent documentation should disclose it. Commercial coverage is sparse, matching 99490. Practices running structured CCM programs find roughly a quarter to a third of enrolled patients exceed 40 staff minutes in active months, so unbilled 99439 units are one of the most common care management revenue leaks. Track minutes in your CCM platform and bill the add-on automatically at the 40 and 60 minute marks.

Pairs well with

Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.