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 Chronic Care Management (CCM) CPT Code Summary

Download your free 2023 CCM codes summary and Implementation Guide

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

Care Coordination

Care management

Speak with a CCM Expert

Consistent care, fewer calls

Replace hundreds of monthly phone calls with weekly personalized text check-ins that patients love.

Work smarter, not harder

Headache-free auto-documenting care management, smart care plan templates and follow-up protocols.

CCM at significant scale

Enroll 500+ patients in 60 days. Not a dead-end side project that goes nowhere fast.