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CCM Codes​

The four CPT codes used to report CCM services are:

  • 99490 non-complex CCM is a 20-minute timed service provided by clinical staff to coordinate care across providers and support patient accountability.

  • 99487 complex CCM is a 60-minute timed services provided by clinical staff to substantially revise or establish comprehensive care plan that involves moderate- to high-complexity medical decision making.

  • 99489 is each additional 30 minutes (cannot be billed with CPT code 99490)

  • 99491 CCM services provided personally by a physician or other qualified health care professional for 30 minutes.

Nurse Taking Notes

Reimbursement for CCM?

Health Care Professionals Who May Furnish and Bill CCM

Advance Care Management

Can Do It All!!

Only one health provider who assumes the care management role for a beneficiary can bill for providing CCM services to that patient in a given calendar month. While services are provided by a clinical staff person, the service must be billed under one of the following:

  • Physician 

  • Clinical nurse specialist (CNS)

  • Nurse practitioner (NP)

  • Physician assistant (PA) 

  • Certified nurse midwife

Non-physicians must legally be authorized and qualified to provide CCM in the state in which the services are furnished.

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