CPT 99491 reports chronic care management delivered personally by a physician or qualified health professional, for at least 30 minutes per calendar month.
When to use 99491
Use 99491 when the physician or qualified health professional personally provides the care management time. Clinical staff time does not count toward this code; for staff-delivered CCM use 99490.
How to bill it
Report once per month for at least 30 minutes of practitioner-provided care management, with patient consent documented.
Common pitfalls
- Counting clinical staff time toward the 99491 threshold.
- Billing 99491 with 99490 in the same month.
Frequently asked questions
Whose time counts for 99491?
Only time personally provided by the physician or qualified health professional counts; clinical staff time does not.
How does 99491 differ from 99490?
99491 is physician/QHP-provided CCM at 30 minutes; 99490 is clinical-staff-delivered CCM at 20 minutes under physician direction.