99490
Chrnc care mgmt staff 1st 20
Chronic Care Management (CCM) services, at least 20 minutes of clinical staff time directed by a physician or QHP per calendar month. Initial billable threshold for monthly CCM; add 99439 for each additional 20 minutes (up to two additional units).
Published by RVUDoc. Numeric data: CMS RVU26C, effective 2026-07-01. Page updated 2026-09-23. Calculation limits and editorial policy.
Fee-schedule estimate before claim adjustments. Coverage, setting and payer rules still apply.
Review Medicare CCM and TCM concurrent-service requirements, separate time accounting and TCM contact and visit deadlines.
Billing guidance for 99490 is locked
- When to use it: the exact clinical situations that support billing 99490
- Documentation checklist: the 7 elements your note needs before submitting
- Common pitfalls: the 6 mistakes that get 99490 downcoded or denied
Payer notes
Medicare and Medicare Advantage plans cover CCM with a patient copay. Some MA plans waive the copay as a value-based-care benefit. Commercial payers generally do not cover 99490 (Medicare-only code); commercial CCM equivalents vary by plan. Document patient consent including any cost share each calendar year, not just at initiation.
Related codes
These include alternative services and possible add-ons. Listing codes together does not establish that they can be billed together; check the applicable edits and payer policy.
See what 99490 adds to your year
Add it to the wRVU calculator with your own volume, or paste a note and let the chart audit check your coding.