What are the billing requirements for CPT 99490?

Minimum 20 minutes of qualifying clinical staff time per calendar month Requires documented patient consent and a comprehensive care plan Only one practitioner may bill CCM for a patient in a given month

Does Healthcare SBC handle billing for 99490?

Yes. Our certified coders bill 99490 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 99490Care Management

CPT Code 99490: Chronic Care Management, First 20 Minutes

CCM, first 20 minutes of clinical staff time

CPT 99490 covers at least 20 minutes of clinical staff time per calendar month directed by a physician for chronic care management of patients with two or more chronic conditions.

What this code covers

Requires two or more chronic conditions expected to last at least 12 months or until death, placing the patient at significant risk.

A comprehensive care plan must be established, implemented, revised and documented.

Patient consent must be obtained and documented before services begin.

Billing and documentation notes

Minimum 20 minutes of qualifying clinical staff time per calendar month
Requires documented patient consent and a comprehensive care plan
Only one practitioner may bill CCM for a patient in a given month

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 99490, frequently asked questions questions

What is CPT code 99490?: CPT 99490 covers at least 20 minutes of clinical staff time per calendar month directed by a physician for chronic care management of patients with two or more chronic conditions.
What are the billing requirements for CPT 99490?: Minimum 20 minutes of qualifying clinical staff time per calendar month Requires documented patient consent and a comprehensive care plan Only one practitioner may bill CCM for a patient in a given month
Does Healthcare SBC handle billing for 99490?: Yes. Our certified coders bill 99490 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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