CCM services are typically provided outside of face-to-face patient visits. The CCM service period is one calendar month. When the 20 minute threshold to bill is met, the practitioner may choose that date as the date of service, and need not hold the claim until the end of the month.
| 99490 | Chronic care management services, at least 20 minutes |
| 99487 | Complex chronic care management services |
| 99489 | Each additional 30 minutes of clinical staff time |
CCM Service Elements Highlights
- Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
- A practitioner must obtain patient consent before furnishing or billing CCM. Consent may be verbal or written but must be documented in the medical record
- Establishment or substantial revision of a comprehensive care plan
- Provide 24/7 access to physicians or other qualified healthcare professionals or clinical staff
Examples of chronic conditions:
Alzheimer’s Disease and Related Dementia
Arthritis (Osteoarthritis and Rheumatoid)
Asthma
Atrial Fibrillation
Autism Spectrum Disorders
Cancer (Breast, Colorectal, Lung, and Prostate)
Cardiovascular Disease
Chronic Kidney Disease
Chronic Obstructive Pulmonary Disease
Depression
Diabetes
Heart Failure
Hepatitis (Chronic Viral B & C)
HIV/AIDS
Hyperlipidemia (High cholesterol)
Hypertension (High blood pressure)
Infectious diseases such as HIV/AIDS
Ischemic Heart Disease
Osteoporosis
Schizophrenia and Other Psychotic Disorders
Stroke