Part of Chronic Care Management
CPT 99490: Non-complex CCM, first 20 minutes of clinical staff time
First 20 minutes per calendar month of non-complex chronic care management furnished by clinical staff, directed by a physician or other qualified health professional.
Time threshold & code combinations
First 20 minutes of clinical staff time per calendar month.
- 99439 is the add-on for each additional 20 minutes, up to two units per month
- Mutually exclusive with 99491 for the same month, choose clinical-staff-time billing or physician-time billing, not both, for the same minutes
- Not billed alongside complex CCM (99487) or APCM for the same patient and period
Who can bill
- Physicians and non-physician practitioners who can bill E/M services, directing the clinical staff who furnish the service
Eligibility & billing requirements
- Two or more chronic conditions expected to last at least 12 months or until death, with significant risk as described in the program overview
- Documented patient consent
- A comprehensive care plan established, implemented, revised, or monitored during the month
- 24/7 access and care coordination activity in place
- Clinical staff time directed by the billing practitioner
When to use it
Two well-managed chronic conditions
A care coordinator spends 20 minutes reviewing medication adherence and updating the care plan for a patient with hypertension and type 2 diabetes.
Billing: 99490
Routine monthly check-in
Staff call a patient with COPD and osteoarthritis to confirm they've filled prescriptions and don't have new symptoms, documenting the call against the care plan.
Billing: 99490
Documentation checklist
- Time log showing at least 20 minutes of clinical staff time
- Care plan entry or revision for the month
- Consent on file
Common billing mistakes
- Billing 99490 when the patient's decision making and time actually support complex CCM (99487) instead
- Logging physician-personal time under this code instead of using 99491