CPT 99490 reports chronic care management (CCM) for patients with two or more chronic conditions, covering at least 20 minutes of clinical staff time per month under physician direction.
When to use 99490
Use 99490 for non-complex CCM delivered by clinical staff. For physician-provided CCM use 99491, for complex CCM use 99487/99489, and for RHC/FQHC settings use G0511.
How to bill it
Report once per calendar month when at least 20 minutes of qualifying care coordination is delivered and patient consent is documented.
Common pitfalls
- Billing 99490 without documented patient consent.
- Double-billing with other care management codes in the same month.
Frequently asked questions
How does 99490 differ from 99491?
99490 is at least 20 minutes of clinical staff time; 99491 is at least 30 minutes of care delivered personally by the physician or qualified health professional.
Is patient consent required?
Yes. CCM requires the patient’s consent to be documented before billing 99490.