CPT Code 99491: CCM by Physician, First 30 Minutes
CCM by physician or QHP, first 30 minutes
CPT 99491 covers at least 30 minutes of chronic care management provided personally by a physician or other qualified health professional, rather than by clinical staff.
What this code covers
The distinguishing feature is that the time is spent personally by the billing practitioner, not clinical staff.
Requires the same two-or-more chronic conditions criteria as 99490.
Cannot be reported in the same month as 99490 for the same patient.
Billing and documentation notes
- Requires 30 minutes of the practitioner's own time
- Mutually exclusive with 99490 in the same month
- Time must be documented and clearly attributable to the practitioner
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 99491, frequently asked questions questions
- What is CPT code 99491?
- CPT 99491 covers at least 30 minutes of chronic care management provided personally by a physician or other qualified health professional, rather than by clinical staff.
- What are the billing requirements for CPT 99491?
- Requires 30 minutes of the practitioner's own time Mutually exclusive with 99490 in the same month Time must be documented and clearly attributable to the practitioner
- Does Healthcare SBC handle billing for 99491?
- Yes. Our certified coders bill 99491 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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