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99490 CPT Code: Chronic Care Management (CCM) Billing

Last Updated: June 5, 2026

Chronic Care Management (CCM) allows practices to bill for the non-face-to-face care they provide to patients every month. CPT 99490 is the base code for this incredibly valuable service.

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2026 Medicare National Fee (99490): Non-Facility (Office): $80.42 · Facility (Hospital): $48.87

Time and Condition Requirements

To successfully bill 99490 ↗, you must meet three strict requirements during the calendar month:

  1. The patient must have two or more chronic continuous or episodic health conditions that are expected to last at least 12 months (or until death).
  2. The conditions must place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.
  3. You must provide at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional.

Medical Necessity & Consent

Verify Medical Necessity

Don't risk a denial. See if your ICD-10 code is on the approved Medicare LCD list.

You must document the patient's verbal or written consent to participate in CCM prior to billing. Your claim should list the specific chronic ICD-10 codes (e.g., E11.9 for Diabetes, I10 for Hypertension) being managed.

NCCI Edits & Add-on Codes

If your staff spends 40 minutes, you can bill the add-on code 99439 ↗ for the additional 20 minutes. Note that CCM cannot be billed in the same month as Transitional Care Management (TCM) for the same patient by the same provider.

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