Chronic Care Management
Billing Done Correctly

Patients with two or more chronic conditions expected to last at least 12 months, or until the death of the patient, where those conditions place the patient at significant risk of decline. The conditions must be documented in the medical record, and the patient needs a comprehensive electronic care plan.

Yes. CCM requires documented patient consent before the first billable service month. The patient must be told that the service is available, that only one practitioner can provide and bill it per month, that cost sharing may apply, and that they can stop the service at any time. We track consent records per patient so the requirement is easy to verify.

The base code, 99490, requires at least 20 minutes of non-face-to-face clinical staff care coordination in a calendar month, directed by a physician or qualified health professional. Each additional complete 20-minute increment is reported with 99439. Complex CCM under 99487 requires at least 60 minutes with moderate or high-complexity medical decision making.

No. For a given patient in a given calendar month you report either base CCM or complex CCM, not both. In the same way, 99491, which covers care management performed personally by the physician, is reported instead of 99490 for that month rather than alongside it. We review the documented time and complexity to pick the correct single code.

No. We work inside your existing EHR and practice management system. Our team pulls the eligibility, time, and care plan data from where it already lives instead of asking your staff to duplicate documentation in a separate tool.

We work the denial instead of writing it off. Most CCM denials come from a missing consent record, an incomplete care plan, not enough documented time, or another practitioner already having billed CCM for the same patient that month. We find the cause, fix what can be fixed, resubmit with supporting documentation, and correct the upstream workflow so it does not happen again.

CPT 99490 is the base code for chronic care management. It covers at least 20 minutes of non-face-to-face care coordination in a calendar month for a patient with two or more chronic conditions. It is billed once per patient per month, alongside any additional 99439 increments the documented time supports.

Yes. Medicare Part B covers CCM services for eligible patients when the consent, care plan, and time requirements under CPT 99490, 99439, 99487, 99489, and 99491 are met. Coverage details and payment amounts can vary by region and by your local Medicare Administrative Contractor.

CCM covers time spent coordinating a patient's overall chronic care, things like medication management and specialist coordination. RPM covers monitoring physiologic data such as blood pressure or glucose readings from connected devices. A patient can often be enrolled in both at once, but the time logged for one cannot also be counted toward the other.

Yes. Patients can stop CCM at any time, and this has to be explained to them as part of the initial consent process. If a patient withdraws partway through a month, only the time actually documented up to that point counts toward the billable minutes for that month.

A standard office visit is billed for a specific date of service when the patient is seen face to face. CCM is billed monthly for non-face-to-face care coordination work, such as phone calls, medication reviews, and care plan updates, that happens between visits rather than during them.