What are the billing requirements for CPT 99487?

Requires 60 minutes of clinical staff time and moderate-to-high complexity MDM Mutually exclusive with 99490 in the same calendar month Documentation must support the complexity level, not just the time

Does Healthcare SBC handle billing for 99487?

Yes. Our certified coders bill 99487 routinely as part of full-service revenue cycle management, including documentation review, correct unit calculation where applicable, modifier application and denial management specific to this code.

CPT 99487Care Management

CPT Code 99487: Complex Chronic Care Management, First 60 Minutes

Complex CCM, first 60 minutes

CPT 99487 covers complex chronic care management requiring at least 60 minutes of clinical staff time and moderate to high complexity medical decision making.

What this code covers

Distinguished from 99490 by both the time threshold and the level of medical decision making required.

Requires establishment or substantial revision of a comprehensive care plan.

Cannot be billed in the same month as 99490 for the same patient.

Billing and documentation notes

Requires 60 minutes of clinical staff time and moderate-to-high complexity MDM
Mutually exclusive with 99490 in the same calendar month
Documentation must support the complexity level, not just the time

Related codes

CPT is a registered trademark of the American Medical Association. This page provides a general summary for educational purposes and is not a substitute for the official CPT code set, payer policy or professional coding judgment. Verify against current official descriptors and applicable payer policy before billing.

FAQ

CPT 99487, frequently asked questions questions

What is CPT code 99487?: CPT 99487 covers complex chronic care management requiring at least 60 minutes of clinical staff time and moderate to high complexity medical decision making.
What are the billing requirements for CPT 99487?: Requires 60 minutes of clinical staff time and moderate-to-high complexity MDM Mutually exclusive with 99490 in the same calendar month Documentation must support the complexity level, not just the time
Does Healthcare SBC handle billing for 99487?: Yes. Our certified coders bill 99487 routinely as part of full-service revenue cycle management, including documentation review, correct unit calculation where applicable, modifier application and denial management specific to this code.

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