Chronic disease management is an essential part of modern Medicare services, with multiple CPT codes on board, which allows healthcare providers to deliver and bill them for the coordination and other non-complex chronic care management services for qualifying patients. With CPT code 99490, it helps practitioners navigate, implement, and scale these services more efficiently while ensuring a strict adherence to billing and compliance needs.
This page is your complete guide if you are a provider, biller, or health administrator who is exploring non-complex CCM options or in search of a reliable partner to manage the service on your behalf.
What Is CPT Code 99490?
A CPT Code is a medical billing code that is used for non-complex Chronic Care Management services. It is designed for patients who are dealing with two or more chronic conditions that are expected to last 12 months or more, conditions that put the patient at a certain risk of death or functional decline.
To bill Medicare CPT 99490, clinical staff should at least provide 20 minutes of non-face-to-face care over the course of a calendar month, under the general supervision of a qualified healthcare provider. This care is directed by a comprehensive care plan, which is then documented, monitored, and can be accessed 24/7.
This CPT code supports the ongoing coordination of care, including medication management, test result review, patient education, and communication between specialists.
Who Can Use CPT 99490?
CPT 99490 is available to a wide range of healthcare professionals and provider organizations. Some of the eligible ones are as follows:
- Physicians (MDs and DOs)
- Nurse Practitioners (NPs)
- Physician Assistants (PAs)
It’s practical and best-suited for primary care, geriatrics, and internal medicine, commonly found in a practice with patients of high volume who are managing multiple chronic diseases.
99490 Billing Guidelines
In the medical domain, time is everything since there’s a huge workload that is widely distributed among workers and medical staff, which means that providers have to ensure that they comply with Medicare’s documentation and time-tracking rules. The billing criteria are as follows:
- Minimum of 20 minutes per month of non-face-to-face care delivered by clinical staff
- Care is provided under the general supervision of the billing provider
- A comprehensive care plan must be developed, monitored, or revised
- 24/7 access to the care plan must be available to all care team members
- Documented patient consent, verbal or written, is required
- Activities must be recorded in the patient’s medical record
- CPT 99490 cannot be billed concurrently with complex CCM codes like 99487 or 99489
2025 Medicare Reimbursement for CPT 99490
As of 2025, Medicare CCM reimbursement rate can’t be calculated exactly since the rate actually varies on multiple factors such as geographic conditions, payer contract, and whether the provider is enrolled in a fee-for-service module or for a Medicare Advantage plan.
Services That Qualify Under CPT 99490
To reimburse CPT 99490, the provider must contribute directly to the patient’s chronic condition management that can be delivered right outside of having a face-to-face conversation; the key qualifying services may include the following:
- Medication reconciliation and management
- Patient education on condition-specific self-care
- Review of test results or specialist recommendations
- Coordination with the community or specialist providers
- Communication with caregivers or family members
- Updates to care plans based on patient condition or response
Common Documentation Requirements
To make sure to comply with the 20-minute CCM code, the following practices must be documented while keeping every aspect in mind that is associated with the CPT 99490. Which means that it includes:
- Time logs showing at least 20 minutes of clinical staff activity
- The active care plan, including goals, interventions, and outcomes
- The presence of two or more qualifying chronic conditions
- Patient consent documentation, either verbal or written
- Any communication or coordination performed on the patient’s behalf
Simplify 99490 Billing with RPM & CCM Health
Here at RPM & CCM Health, we guarantee to provide an end-to-end chronic care management solution for all billing providers who have the CPT Code 99490. Our white-label model lets your practice drive compliant CCM services without needing staff or building workflows from scratch.
Here’s what makes our service different:
- A fully credentialed care team that operates under your brand.
- Built-in billing compliance and documentation support.
- Seamless integration with your existing EHR or platform.
- Transparent monthly reporting and patient-level analytics.
- Patient consent tracking, care planning, and time documentation.
- Scalable services that grow with your practice.
It’s our responsibility to take the complexity out of CCM so that your team can focus more on the patient’s health, not on paperwork.
Book a free discovery call today to learn how we can manage CPT 99490.
Related Chronic Care Management CPT Codes
- CPT 99439: Add-on code for an additional 20 minutes of non-complex CCM
- CPT 99487: Complex CCM for 60+ minutes of care
- CPT 99489: Add-on code for an additional 30 minutes of complex CCM
- CPT 99453/99454: Remote patient monitoring device setup and data transmission
- CPT 99457/99458: Interactive RPM time-based codes
Frequently Asked Questions About CPT 99490
What is the minimum time requirement for CPT 99490?
At least 20 minutes of non-face-to-face clinical staff time must be provided within a calendar month.
Can CPT 99490 be billed with RPM codes?
Yes, CPT 99490 can be billed with remote patient monitoring codes such as 99453, 99454, and 99457, provided all services are distinct and not duplicated.
Does 99490 require patient consent?
Yes, patient consent, either verbal or written, must be documented in the medical record before services are billed.
How often can CPT 99490 be billed?
CPT 99490 can be billed once per month per eligible patient, assuming all criteria are met.
Who can deliver the services billed under CPT 99490?
Clinical staff operating under the general supervision of the billing provider can deliver the services. These staff members must be part of the care team and properly credentialed.
Partner with RPM & CCM Health
By partnering with RPM & CCM Health, you are not just getting a trusted partner, but you are getting a partner onboard who can manage CPT codes, from compliance documentation to reporting, we simplify your CCM strategy!
Contact us now to schedule a free consultation.
