Chronic Care Management
2021 CCM Codes & Reimbursement Fee Schedule
Chronic Care Management (CCM) is a new Medicare program that reimburses an additional $41-$177+ per patient per month for the support you and your staff regularly provide patients between visits, e.g. answering questions, refills, referrals, labs, follow-up phone calls, etc.
HCPCS G0506 - Comprehensive Assessment & Care Planning $62
- 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
CPT 99490 - Standard CCM $41
- 20+ minutes of care management outside of office visits performed by clinical staff
- Care plan established and regularly reviewed
- RHCs and FQHCs should bill HCPCS G0511 instead
CPT 99439 - Non-complex Add-on (New in 2021) $38 x 2
- Was previously HCPCS G2058 in 2020
- Additional 20 minutes of “non-complex” CCM
- Reportable up to 2x per month (after 99490)
CPT 99487 - Complex CCM $92
- 60+ minutes of care management outside office visits
- Care plan created and/or significantly revised
CPT 99489 - Complex Add-on $44
- Billed incrementally for each additional 30 minutes spent beyond the first 60 minutes for Complex CCM case
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
Download our FREE CCM Billing Codes Summary
BONUS: Learn how avoid 3 major CCM mistakes.
A typical provider can enroll 250 CCM patients and generate $125,000+ per year.
However, most practices actually lose money because they simply do CCM wrong.