CHRONIC CARE MANAGEMENT GUIDELINES

2025 CHRONIC CARE MANAGEMENT (CCM) CPT CODES

Practices that use Phamily can generate over $300 per patient in extra profit annually.

Chronic Care Management Billing Codes Summary

Chronic Care Management (CCM) is a Medicare program that offers significant monthly reimbursement for the time providers and their staff spend helping patients between office visits.

CCM reimburses an additional $60-$131+ per patient per month for the support you and your staff regularly provide patients between visits.

CMS continues to increase the number of Chronic Care Management codes providers can bill for. Starting with just one code in 2015, CPT 99490, the Physician Fee-Schedule now includes 7 codes accounting for various levels of complexity and time.

NOTE: These Non-Facility amounts are for the National Payment Amount (MAC Locality 0000000) and no adjustments have been made for Relative Value Units (RVUs), Geographic Practice Cost Indices (GPCIs), or Conversion Factors that might be applied on a practice-by-practice basis.

CCM Code	Description	Reimbursement
CPT 99490 – Standard CCM	20+ minutes of care management outside of office visits performed by clinical staff Care plan established and regularly reviewed	$60.49
CPT 99439 – Non-Complex Add-On	Additional 20 minutes of “non-complex” CCM Reportable up to 2x per month (after 99490)	$45.93 x 2
CPT 99487 – Complex CCM	60+ min of care management outside office visits Care plan created and/or significantly revised	$131.65
CPT 99489 – Complex CCM	Billed incrementally for each additional 30 minutes spent beyond the first 60 minutes for Complex CCM case	$70.52
HCPCS G0506 – Comprehensive Assessment & Care Planning	Patient enrolled in person Systematic assessment & care planning personally performed by the billing provider Add-on code to the standard E&M code (99212-99215), AWV or IPPE initiating visit	$60.81
CPT 99491 – Physician-provided CCM	30+ minutes of care management outside of office visits Provided personally by a physician or other qualified healthcare professional	$82.16
CPT 99437 – Physician-provided CCM Add-On	Additional 20 minutes of care management outside of office visits Provided personally by physician or other qualified healthcare professional	$57.58

Stop doing work for free!

Your practice is already doing many activities that qualify for Medicare CCM reimbursement.

Admin Activities

Care Coordination

Care management

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