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. CMS 2026 wRVU 1.00. Initial billable threshold for monthly CCM; add 99439 for each additional 20 minutes (up to two additional units).
A patient discharged from the hospital can trigger both chronic care management and transitional care management. Since 2020 Medicare allows both in the same month. Here is how to bill both without a denial, and when to pick one.
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.