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.

Reimbursement for CCM?

Advance Care Management

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Nurse Taking Notes

Health Care Professionals Who May Furnish and Bill CCM

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.