CPT code 99489: Complex chronic care management, each additional 30 minutes2026 Medicare rate & RVUs in Virgin Islands, VI
Add-on for each additional 30 minutes of clinical staff complex chronic care management in a calendar month, beyond the first 60 minutes reported with 99487.
In Virgin Islands, VI, Medicare pays $78.59 for 99489 in the office and $43.81 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 99489 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 99489 covers
Complex chronic care management is a monthly, non-face-to-face service for patients with two or more chronic conditions expected to last at least 12 months or until death and posing significant risk of death, acute exacerbation, or functional decline. Clinical staff, such as nurses and medical assistants working under the direction of a physician or qualified health care professional, coordinate with specialists, home health agencies, and pharmacies, manage medications, educate patients and caregivers, and maintain the care plan. Primary care practices, geriatric clinics, and nephrology or cardiology groups managing high-needs patients are typical billers.
Code 99489 captures additional clinical staff time after the first 60 minutes reported with 99487 in the same calendar month. The first 99489 unit requires at least 90 total minutes; each further unit requires another 30 minutes. The primary service requires moderate or high complexity medical decision making and establishment or substantial revision of a comprehensive care plan. Document dated staff activities and cumulative time, patient consent, and the care plan. CMS classifies 99489 as an add-on, payable only with its primary service within that service's global period. Its practice expense RVUs are higher in the office than in a facility.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Virgin Islands, VI compares for 99489
Across 109 of 109 payment localities, the office rate for 99489 runs from $71.04 in Arkansas to $99.50 in San Benito County, CA. Virgin Islands, VI pays $78.59. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virgin Islands, VI · this page$78.59
- Los Angeles, CA · California$86.50+$7.91
- Washington, DC area · District of Columbia$87.78+$9.19
- Miami, FL · Florida$83.47+$4.88
- Chicago, IL · Illinois$81.63+$3.04
- Manhattan, NY · New York$88.54+$9.95
- Alaska · Alaska$96.57+$17.98
Other areas in United States Virgin Islands first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $71.84 | $41.74 |
| ArkansasArkansas | $71.04 | $41.49 |
| ArizonaArizona | $76.51 | $43.17 |
| Bakersfield, CACalifornia | $81.95 | $44.25 |
| Chico, CACalifornia | $81.71 | $44.01 |
| El Centro, CACalifornia | $81.72 | $44.02 |
| Fresno, CACalifornia | $81.71 | $44.01 |
| Hanford, CACalifornia | $81.71 | $44.01 |
| Madera, CACalifornia | $81.71 | $44.01 |
| Merced, CACalifornia | $81.71 | $44.01 |
| Modesto, CACalifornia | $81.71 | $44.01 |
| Napa, CACalifornia | $92.60 | $47.26 |
| Oxnard, CACalifornia | $85.93 | $45.27 |
| Redding, CACalifornia | $81.71 | $44.01 |
| Rest of CaliforniaCalifornia | $81.71 | $44.01 |
| Riverside, CACalifornia | $82.49 | $44.78 |
| Sacramento, CACalifornia | $85.19 | $45.18 |
| Salinas, CACalifornia | $84.85 | $44.98 |
| San Diego, CACalifornia | $86.40 | $45.26 |
| Marin County, CACalifornia | $97.46 | $48.95 |
| San Francisco, CACalifornia | $97.38 | $48.87 |
| San Benito County, CACalifornia | $99.50 | $49.89 |
| Santa Clara County, CACalifornia | $99.17 | $49.56 |
| San Luis Obispo, CACalifornia | $83.54 | $44.35 |
| Santa Cruz, CACalifornia | $86.89 | $45.10 |
| Santa Maria, CACalifornia | $85.05 | $44.94 |
| Santa Rosa, CACalifornia | $87.75 | $45.50 |
| Stockton, CACalifornia | $81.71 | $44.01 |
| Vallejo, CACalifornia | $92.49 | $47.14 |
| Visalia, CACalifornia | $81.71 | $44.01 |
| Yuba City, CACalifornia | $81.71 | $44.01 |
| ColoradoColorado | $80.76 | $44.16 |
| ConnecticutConnecticut | $82.58 | $45.53 |
| DelawareDelaware | $77.58 | $43.59 |
| Fort Lauderdale, FLFlorida | $80.60 | $45.75 |
| Rest of FloridaFlorida | $77.47 | $44.58 |
| Atlanta, GAGeorgia | $79.41 | $44.45 |
| Rest of GeorgiaGeorgia | $74.03 | $43.34 |
| Hawaii, Guam, HIHawaii | $82.99 | $43.87 |
| IowaIowa | $73.14 | $41.66 |
| IdahoIdaho | $73.53 | $41.88 |
| East St. Louis, ILIllinois | $77.14 | $45.48 |
| Rest of IllinoisIllinois | $75.78 | $44.37 |
| Suburban Chicago, ILIllinois | $81.34 | $46.01 |
| IndianaIndiana | $73.86 | $41.97 |
| KansasKansas | $72.93 | $41.83 |
| KentuckyKentucky | $73.25 | $42.67 |
| New Orleans, LALouisiana | $75.97 | $43.60 |
| Rest of LouisianaLouisiana | $73.18 | $42.74 |
| Metropolitan Boston, MAMassachusetts | $87.50 | $46.42 |
| Rest of MassachusettsMassachusetts | $80.47 | $44.24 |
| Baltimore area, MDMaryland | $82.34 | $45.43 |
| Rest of MarylandMaryland | $78.81 | $43.99 |
| Rest of MaineMaine | $73.88 | $42.23 |
| Southern Maine, MEMaine | $76.91 | $42.82 |
| Detroit, MIMichigan | $78.28 | $45.08 |
| Rest of MichiganMichigan | $74.77 | $43.36 |
| MinnesotaMinnesota | $77.74 | $42.34 |
| Metropolitan Kansas City, MOMissouri | $75.52 | $43.21 |
| Metropolitan St. Louis, MOMissouri | $76.13 | $43.38 |
| Rest of MissouriMissouri | $72.24 | $42.59 |
| MississippiMississippi | $71.65 | $42.03 |
| MontanaMontana | $78.15 | $43.75 |
| North CarolinaNorth Carolina | $74.47 | $42.37 |
| North DakotaNorth Dakota | $76.77 | $42.37 |
| NebraskaNebraska | $73.44 | $41.68 |
| New HampshireNew Hampshire | $79.61 | $43.79 |
| Northern New JerseyNew Jersey | $87.21 | $47.30 |
| Rest of New JerseyNew Jersey | $83.62 | $46.06 |
| New MexicoNew Mexico | $75.11 | $43.56 |
| NevadaNevada | $77.81 | $43.37 |
| NYC suburbs and Long Island, NYNew York | $90.32 | $49.41 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $84.18 | $46.51 |
| Queens, NYNew York | $89.05 | $48.39 |
| Rest of New YorkNew York | $75.34 | $42.66 |
| OhioOhio | $74.49 | $43.08 |
| OklahomaOklahoma | $73.10 | $42.38 |
| Portland, OROregon | $82.80 | $44.58 |
| Rest of OregonOregon | $77.29 | $43.03 |
| Metropolitan Philadelphia, PAPennsylvania | $80.95 | $45.14 |
| Rest of PennsylvaniaPennsylvania | $74.55 | $42.97 |
| Puerto RicoPuerto Rico | $78.59 | $43.81 |
| Rhode IslandRhode Island | $79.94 | $44.40 |
| South CarolinaSouth Carolina | $74.58 | $42.80 |
| South DakotaSouth Dakota | $76.61 | $42.20 |
| TennesseeTennessee | $73.22 | $41.94 |
| Austin, TXTexas | $80.42 | $44.02 |
| Beaumont, TXTexas | $74.17 | $42.87 |
| Brazoria, TXTexas | $77.53 | $43.44 |
| Dallas, TXTexas | $77.96 | $43.69 |
| Fort Worth, TXTexas | $77.56 | $43.64 |
| Galveston, TXTexas | $77.73 | $43.56 |
| Houston, TXTexas | $79.01 | $44.85 |
| Rest of TexasTexas | $75.77 | $43.12 |
| UtahUtah | $75.37 | $43.04 |
| VirginiaVirginia | $76.75 | $42.93 |
| VermontVermont | $76.58 | $42.52 |
| Rest of WashingtonWashington | $80.28 | $44.06 |
| King County, WAWashington | $89.03 | $46.82 |
| WisconsinWisconsin | $74.76 | $41.80 |
| West VirginiaWest Virginia | $73.61 | $43.71 |
| WyomingWyoming | $77.55 | $43.15 |
99489 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$71.04
$96.57
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $96.57 | 1 |
| AL | $71.84 | 1 |
| AR | $71.04 | 1 |
| AZ | $76.51 | 1 |
| CA | $81.71–$99.50 | 29 |
| CO | $80.76 | 1 |
| CT | $82.58 | 1 |
| DC | $87.78 | 1 |
| DE | $77.58 | 1 |
| FL | $77.47–$83.47 | 3 |
| GA | $74.03–$79.41 | 2 |
| GU | $82.99 | 1 |
| HI | $82.99 | 1 |
| IA | $73.14 | 1 |
| ID | $73.53 | 1 |
| IL | $75.78–$81.63 | 4 |
| IN | $73.86 | 1 |
| KS | $72.93 | 1 |
| KY | $73.25 | 1 |
| LA | $73.18–$75.97 | 2 |
| MA | $80.47–$87.50 | 2 |
| MD | $78.81–$87.78 | 3 |
| ME | $73.88–$76.91 | 2 |
| MI | $74.77–$78.28 | 2 |
| MN | $77.74 | 1 |
| MO | $72.24–$76.13 | 3 |
| MS | $71.65 | 1 |
| MT | $78.15 | 1 |
| NC | $74.47 | 1 |
| ND | $76.77 | 1 |
| NE | $73.44 | 1 |
| NH | $79.61 | 1 |
| NJ | $83.62–$87.21 | 2 |
| NM | $75.11 | 1 |
| NV | $77.81 | 1 |
| NY | $75.34–$90.32 | 5 |
| OH | $74.49 | 1 |
| OK | $73.10 | 1 |
| OR | $77.29–$82.80 | 2 |
| PA | $74.55–$80.95 | 2 |
| PR | $78.59 | 1 |
| RI | $79.94 | 1 |
| SC | $74.58 | 1 |
| SD | $76.61 | 1 |
| TN | $73.22 | 1 |
| TX | $74.17–$80.42 | 8 |
| UT | $75.37 | 1 |
| VA | $76.75–$87.78 | 2 |
| VI | $78.59 | 1 |
| VT | $76.58 | 1 |
| WA | $80.28–$89.03 | 2 |
| WI | $74.76 | 1 |
| WV | $73.61 | 1 |
| WY | $77.55 | 1 |
How the 99489 rate is calculated
Each of 99489’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 99489
RVUs × geographic indexes × conversion factor
Work1.00
1.00 RVUs× 1.000 GPCI
Practice expense1.27
1.27 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
2.3400
Conversion factor
$33.4009
Medicare rate
$78.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virgin Islands, VI inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,153
- Code
- 99489
- Physician work
- 1.00
- Practice expense
- 1.27
- Malpractice
- 0.07
GPCI2026.csv
107
- Locality
- Virgin Islands, VI
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.00 | × 1.000 | 1.0000 |
| Practice expense | 1.27 | × 1.011 | 1.2840 |
| Malpractice | 0.07 | × 0.985 | 0.0690 |
| Total RVUs | 2.3529 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virgin Islands, VI$78.59
Office: (1 × 1 + 1.27 × 1.011 + 0.07 × 0.985) × $33.4009 = $78.59
Facility: (1 × 1 + 0.24 × 1.011 + 0.07 × 0.985) × $33.4009 = $43.81
Payment rules and modifiers for 99489
The CMS indicators that decide how 99489 is paid alongside other services.
CMS payment indicators · 99489
Complex chronic care management, each additional 30 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
How 99489 has changed in Virgin Islands, VI
99489 · Office / nonfacility
$78.59
Effective 2026-10-01
The base rate is $7.86 higher than on 2025-10-01, moving from $70.73 to $78.59 (11.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$70.73changed to$78.59
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.12 changed to 1.27
- Malpractice RVU 0.06 changed to 0.07
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$72.45changed to$70.73
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.10 changed to 1.12
- Malpractice RVU 0.07 changed to 0.06
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$71.27changed to$72.45
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$70.72changed to$71.27
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.01 changed to 1.10
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$70.49changed to$70.72
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$70.83changed to$70.49
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.97 changed to 1.01
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$44.15changed to$70.83
- Conversion factor 34.8931 changed to 34.6062
- Work RVU 0.50 changed to 1.00
- Practice expense RVU 0.72 changed to 0.97
- Malpractice RVU 0.04 changed to 0.07
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$44.94changed to$44.15
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.71 changed to 0.72
- Malpractice RVU 0.03 changed to 0.04
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$46.67changed to$44.94
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.76 changed to 0.71
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$47.35changed to$46.67
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.78 changed to 0.76
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$47.17changed to$47.35
- Conversion factor 35.8887 changed to 35.9996
- Practice expense GPCI 1.006 changed to 1.007
- Malpractice GPCI 0.993 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$47.17
Held through RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $78.59 | $43.81 | RVU26D |
| 2026-07-01 | $78.59 | $43.81 | RVU26C |
| 2026-04-01 | $78.59 | $43.81 | RVU26B |
| 2026-01-01 | $78.59 | $43.81 | RVU26A |
| 2025-10-01 | $70.73 | $47.28 | RVU25D |
| 2025-07-01 | $70.73 | $47.28 | RVU25C |
| 2025-04-01 | $70.73 | $47.28 | RVU25B |
| 2025-01-01 | $70.73 | $47.28 | RVU25A |
| 2024-10-01 | $72.45 | $49.65 | RVU24D |
| 2024-07-01 | $72.45 | $49.65 | RVU24C |
| 2024-04-01 | $72.45 | $49.65 | RVU24B |
| 2024-03-09 | $72.45 | $49.65 | RVU24AR |
| 2024-01-01 | $71.27 | $48.84 | RVU24A |
| 2023-10-01 | $70.72 | $50.23 | RVU23D |
| 2023-07-01 | $70.49 | $50.15 | RVU23C |
| 2023-04-01 | $70.49 | $50.15 | RVU23B |
| 2023-01-01 | $70.49 | $50.15 | RVU23A |
| 2022-10-01 | $70.83 | $51.30 | RVU22D |
| 2022-07-01 | $70.83 | $51.30 | RVU22C |
| 2022-04-01 | $70.83 | $51.30 | RVU22B |
| 2022-01-01 | $70.83 | $51.30 | RVU22A |
| 2021-10-01 | $44.15 | $25.86 | RVU21D |
| 2021-07-01 | $44.15 | $25.86 | RVU21C |
| 2021-04-01 | $44.15 | $25.86 | RVU21B |
| 2021-01-01 | $44.15 | $25.86 | RVU21A |
| 2020-10-01 | $44.94 | $26.39 | RVU20D |
| 2020-07-01 | $44.94 | $26.39 | RVU20C |
| 2020-04-01 | $44.94 | $26.39 | RVU20B |
| 2020-01-01 | $44.94 | $26.39 | RVU20A |
| 2019-10-01 | $46.67 | $26.71 | RVU19D |
| 2019-07-01 | $46.67 | $26.71 | RVU19C |
| 2019-04-01 | $46.67 | $26.71 | RVU19B |
| 2019-01-01 | $46.67 | $26.71 | RVU19A |
| 2018-10-01 | $47.35 | $26.68 | RVU18D |
| 2018-07-01 | $47.35 | $26.68 | RVU18C |
| 2018-04-01 | $47.35 | $26.68 | RVU18B |
| 2018-01-01 | $47.35 | $26.68 | RVU18AR1 |
| 2017-10-01 | $47.17 | $26.60 | RVU17D |
| 2017-07-01 | $47.17 | $26.60 | RVU17C |
| 2017-04-01 | $47.17 | $26.60 | RVU17B |
| 2017-01-01 | $47.17 | $26.60 | RVU17A |
| 2016-10-01 | Separate payment rules apply | Separate payment rules apply | RVU16D |
| 2016-07-01 | Separate payment rules apply | Separate payment rules apply | RVU16C |
| 2016-04-01 | Separate payment rules apply | Separate payment rules apply | RVU16B |
| 2016-01-01 | Separate payment rules apply | Separate payment rules apply | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Separate payment rules apply | Separate payment rules apply | RVU14D |
| 2014-07-01 | Separate payment rules apply | Separate payment rules apply | RVU14C |
| 2014-04-01 | Separate payment rules apply | Separate payment rules apply | RVU14B |
| 2014-01-01 | Separate payment rules apply | Separate payment rules apply | RVU14A |
| 2013-10-01 | Separate payment rules apply | Separate payment rules apply | RVU13D |
| 2013-07-01 | Separate payment rules apply | Separate payment rules apply | RVU13C |
| 2013-04-01 | Separate payment rules apply | Separate payment rules apply | RVU13B |
| 2013-01-01 | Separate payment rules apply | Separate payment rules apply | RVU13AR |
Where the Virgin Islands, VI rate applies
Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.
- Charlotte Amalie
- Charlotte Amalie East
- Charlotte Amalie West
- Christiansted
- Coral Bay
- Cruz Bay
- Frederiksted
- Frederiksted Southeast
99489 billing questions
Can 99489 be reported without 99487?
No. Report it with 99487 for the same patient's complex chronic care management in the same calendar month.
Can 99489 be reported with 99439 or 99490 in the same month?
No. Complex and non-complex chronic care management are not reported together for the same patient by the same practitioner in a calendar month.
Whose time counts toward 99489?
Count clinical staff time spent under the direction of the billing physician or qualified health care professional during the calendar month. Exclude time spent on separately reported services.
What documentation supports 99489?
Document dates, staff members, activities, and minutes for the month, along with patient consent, the comprehensive care plan and its establishment or substantial revision, and the moderate or high complexity medical decision making.
How are multiple units of 99489 reported?
Report the first unit with 99487 when total clinical staff time reaches 90 minutes in the calendar month. Each additional unit requires another 30 minutes.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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