Geri / CCM

Geriatrics & Care Management

Heavy on Medicare wellness, chronic care management, transitional care, advance care planning, cognitive assessment, and SDOH. These are time-based codes with strict documentation; getting the documentation right turns 20 minutes of phone work into real RVUs.

Top billed codes

The codes that drive revenue in this specialty. Click any code for documentation requirements, modifiers, and pitfalls.

CodeDescriptionwRVUTotal RVUMedicare $
G0438
Ppps, initial visit
First AWV for a Medicare beneficiary who is past the 12-month IPPE window. Once per lifetime.
2.605.22$174Details →
G0439
Ppps, subseq visit
Every year after the initial AWV. Cannot be billed within 12 months of the prior AWV.
1.924.12$138Details →
99490
Chrnc care mgmt staff 1st 20
Patient with 2+ chronic conditions expected to last 12+ months. Initial 20 minutes of staff time in a calendar month.
1.001.98$66Details →
99439
Chrnc care mgmt staf ea addl
Add-on to 99490 for each additional 20 minutes of clinical staff time, max 2 units (40 additional minutes).
0.701.51$50Details →
99495
Transj care mgmt mod f2f 14d
Post-discharge transition. Phone contact within 2 business days, face-to-face visit within 14 days.
2.786.59$220Details →
99496
Transj care mgmt high f2f 7d
Post-discharge transition with high-complexity MDM and face-to-face within 7 days.
3.798.94$299Details →
99497
Advncd care plan 30 min
Discussion of advance directives, healthcare proxy, goals of care. Patient must be present at start unless meeting with a surrogate is explicitly billed.
1.502.60$87Details →
99498
Advncd care plan addl 30 min
Add-on to 99497 for each additional 30 minutes.
1.402.34$78Details →
99483
Cognitive assessment & care plan
Patient with mild cognitive impairment, dementia, or suspicion thereof. Once per 180 days.
3.446.08$203Details →
G0136
SDOH risk assessment, 5-15 min
Once per year per beneficiary. Requires a standardized SDOH screening tool.
0.180.37$12Details →
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Educational reference, not billing or legal advice. Coverage curated, not exhaustive. Verify against payer contracts.