Chronic Care Management guidelines
2022 Chronic Care Management (CCM) Codes CPT Codes
Practices that use Phamily can generate over $300 per patient in extra profit yearly.
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.
Chronic Care Management (CCM) reimburses an additional $64-$177+ per patient per month for the support you and your staff regularly provide patients between visits.
Get reimbursed for:
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
Activities you already perform everyday
Chronic Care Management Billing Codes Summary
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.
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HCPCS G0506 - Comprehensive Assessment & Care Planning $64
- 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
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CPT 99490 - Standard CCM $64
- 20+ minutes of care management outside of office visits performed by clinical staff
- Care plan established and regularly reviewed
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CPT 99439 - Non-complex Add-on $48.45 x 2
- Additional 20 minutes of “non-complex” CCM
- Reportable up to 2x per month (after 99490)
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CPT 99487 - Complex CCM $93
- 60+ minutes of care management outside office visits
- Care plan created and/or significantly revised
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CPT 99489 - Complex Add-on $45
- Billed incrementally for each additional 30 minutes spent beyond the first 60 minutes for Complex CCM case
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CPT 99491 - Physician-provided CCM $82
- 30+ minutes of care management outside of office visits
- Provided personally by a physician or other qualified healthcare professional
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CPT 99437 - Physician-provided CCM Add-on $61
- Additional 20 minutes of care management outside of office visits
- Provided personally by physician or other qualified healthcare professional
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 meet that 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 and plan to reach 5,000 by September… 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