Your Guide to Maximizing Your CPT 99490 Reimbursement

[Leah Flair]

CPT code 99490 can be billed for the initial twenty minutes of non-face-to-face care provided and documented for the patient each calendar month. Reimbursement for this service can vary by state and practice type – for instance, Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) are typically reimbursed at a higher rate than a standard practice. Prior to billing for CCM monthly services (99490 or G0511) for the first time, you may elect to bill G0506, face-to-face CCM Consent, for patients as they come in to see their provider.  Those who provide continued care planning after the 20 minutes of billable time required for CPT 99490 within a month may be eligible to bill for Complex Chronic Care Management, which has additional requirements for clinical staff time and a higher level of medical decision-making. 

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