Chronic Care Management guidelines
2023 Chronic Care Management (CCM) CPT Codes
Practices that use Phamily can generate over $300 per patient in extra profit annually.
2023 CCM CPT Codes
Chronic Care Management Billing Codes Summary
Chronic Care Management (CCM) is a new Medicare program that offers significant monthly reimbursement for the time providers and their staff spend helping patients between office visits.
CCM reimburses an additional $64-$177+ 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 8 codes accounting for various levels of complexity and time.
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
$61.16
CPT 99439 – Non-complex Add on
- Additional 20 minutes of “non-complex”
- CCM Reportable up to 2x per month (after 99490)
$46.28 x 2
CPT 99487 – Complex CCM
- 60+ min of care management outside office visits
- Care plan created and/or significantly revised
$129.93
CPT 99489 – Complex CCM
- Billed incrementally for each additional 30 minutes spent beyond the first 60 minutes for Complex CCM case
$68.76
HCPCS G0511 – RHC or FQHC
- 20+ minutes of CCM or behavioral health integration services directed by a provider at a Rural Health Clinic or Federally Qualified Health Center
$76.04
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
$60.50
CPT 99491 – Physician-provided CCM
- 30+ minutes of care management outside of office visits
- Provided personally by a physician or other qualified healthcare professional
$82.98
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
$58.52
get reimbursed
Activities you already perform everyday
Admin Activities
- Medical refills
- Prior authorizations
- Chart reviews
- Chart preparation
- Chart updates
- Lab reviews
Care Coordination
- Referrals
- ER follow-up
- Discharge follow-up
- Communication with providers
Care management
- Phone calls
- Text messages
- Voicemails
- Follow-up
- Symptom Management
- Triage and care
Grow your ccm program
Phamily helps you grow your CCM programs to 500+ patients in 60 days...
"At Silver Cross, our primary mission is "caring for our community." My job is to make sure we fulfill that mission across our patient populations and practice groups, and do it in a sustainable way. That's why the first time I saw the Phamily platform I immediately recognized the flexibility and potential it had for population health delivery… In just a few months we’ve enrolled more than 3,200 Medicare patients. The program is fully self-sustaining and our patients, providers, and leadership all love it."
Lisa Stockdale
Director of Value-Based Care
Silver Cross Hospital, New Lenox, Il
Silver Cross Hospital, New Lenox, Il