Delivering effective chronic care means you need to stay connected always, even if the patient isn’t in the exam room. As we see more practices shift towards more proactive, non-face-to-face approaches, Medicare has expanded its reimbursement pathways to reflect the additional effort. CPT code 99439 is one code that allows providers to bill for an additional 20 minutes of chronic care management delivered under general supervision.
At RPM & CCM Health, we take care of the primary care practices, such as FQHCs, and the health system to efficiently implement and scale their chronic care programs, ensuring compliance and profitability. Below, you will be learning when and how to bill time-based CCM codes, what the criteria are, and how we can support you in every step that you take.
What Is CPT Code 99439?
For basic understanding, medicare CPT 99439 is an additional billing code that is used to cite each additional 20 minutes of non-complex CCM provided in a calendar month. It must always be billed along with the CPT 99490, which covers the first 20 minutes of care.
Like 99490, services must be:
- Non-face-to-face
- Performed by clinical staff under general supervision
- Directed toward patients with two or more chronic conditions
- Intended to prevent functional decline or hospitalization
This code strategically follows the same standard as its basic code and plays a pivotal role in expanding reimbursement opportunities through the chronic care management time add-on billing.
When and How to Bill CPT 99439
Having a broad understanding of when and how to use these codes, it’s important to follow the 99439 billing guideline, which is essential for ensuring reimbursement without any compliance risk. For that, a few conditions are mandatory to be met:
- The base code CPT 99490 must also be billed that same month
- Each billed unit represents 20 minutes of additional CCM time
- Time must be delivered by clinical staff under general supervision
- Services must be non-face-to-face and properly linked to the patient’s care plan
- This code cannot be billed with complex CCM codes like 99487 or 99489
Medicare Guidelines and Reimbursement
As of 2025, the national average for medicare reimbursement for CPT 99439 couldn’t be calculated as it is highly volatile due to various factors such as time, location, and time taken during this process.
Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) are eligible to bill this code when integrated into their general care management program , subject to CMS guidelines.
Keeping up with the latest CMS chronic care codes helps ensure your practice is aligned with evolving federal policies.
Qualifying Services for CPT 99439
Services that qualify under this code are all non-face-to-face, usually all administrative, yet critical to high-quality care, a few of the examples are:
- Reviewing or updating care plans
- Coordinating with specialists for referrals or test results
- Reviewing patient medications for risks or adherence issues
- Communicating with pharmacies or scheduling follow-ups
- Educating the patient or caregiver on disease management
- Updating the EHR with lab results or care progress
These activities highly contribute and play their part in the continuity of care and meet Medicare’s criteria for the next 20 minutes of CCM services.
Key Documentation Requirements
To ensure compliance and support reimbursement, your documentation should reflect the following:
- Total time spent per unit, tracked and verifiable
- Identity of clinical staff delivering the service
- A direct link to the patient’s care plan
- Patient consent was captured and recorded
- Clear justification of medical necessity
These records also support proper CCM billing modifiers and are vital for audit-readiness.
Streamline CPT 99439 Billing with RPM & CCM Health
We agree, handling and dealing with multiple tasks at once can be overwhelming for you, and reporting right for every 20-minute period can put an additional burden, which is why RPM & CCM Health offers a full service that supports your chronic care billing and delivery.
We provide:
- Automated time tracking tools are built into our platform
- A team of qualified clinical staff trained in CCM protocols
- Compliant documentation workflows aligned with Medicare standards
- Seamless EHR integration for efficient care tracking
- Monthly reports and dashboards for CMS audit-readiness
So if you are just starting or on the lookout to scale up your program, we help you bill confidently all across time-based CCM codes such as 99490 and 99439.
Book a consultation call right now to learn more about how we can support your objectives.
Related Chronic Care Management Codes
To build a complete CCM billing strategy, it’s important to understand how CPT 99439 fits into the larger picture:
- CPT 99490 – Base code for the initial 20 minutes of non-complex CCM
- CPT 99487 – Covers complex CCM with 60+ minutes and high-complexity care
- CPT 99489 – Add-on code for each additional 30 minutes of complex CCM
- CCM Services Overview – Learn how all chronic care codes work together
Frequently Asked Questions About CPT 99439
Can CPT 99439 be billed without 99490?
No. CPT 99439 is an add-on code and must be billed in conjunction with CPT 99490.
Is there a monthly cap on how many times 99439 can be billed?
There is no preset limit, but each 20-minute unit must be medically necessary and properly documented.
Can 99439 be billed with RPM codes?
Yes, it can be billed in the same month as remote patient monitoring (RPM) services if all conditions are met for each service independently.
How should time be documented for CPT 99439?
Use precise time logs, identifying the date, service type, staff member, and duration. Link each activity to the patient’s care plan.
Who is eligible to provide services under CPT 99439?
Clinical staff, such as nurses or medical assistants, may provide these services under the general supervision of a physician or qualified healthcare provider.
Ready to Maximize Your Chronic Care Management Program?
With CPT Code 99439, you can capture additional reimbursement for the care your team is already delivering. Let RPM & CCM Health streamline your workflows, reduce overhead, and help you serve more patients, more effectively.
Request a Demo today to explore our full-service CCM platform.
