CPT code 99490: Chronic care management, clinical staff, first 20 minutes2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $73.61 for 99490 in the office and $47.25 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 99490 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 99490 covers

This service coordinates care for patients with at least two chronic conditions expected to last 12 months or until death and posing significant risk of death, acute exacerbation, or functional decline. Clinical staff working under a physician or qualified health care professional may review medications, update the care plan, coordinate with specialists or home health, and follow up by phone or portal. Primary care and internal medicine practices commonly furnish this care between visits.

Report 99490 once per calendar month when clinical staff time reaches 20 minutes; report each additional full 20 minutes with 99439. Document consent, qualifying conditions, the comprehensive care plan, activities performed, and the time spent. For new patients or those not seen in the prior year, CMS requires an initiating face-to-face visit, such as an E/M visit, annual wellness visit, or initial preventive physical examination. Staff may furnish CCM under general supervision. Only one practitioner may bill CCM for a patient in a calendar month.

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 Washington, DC area compares for 99490

Across 109 of 109 payment localities, the office rate for 99490 runs from $60.71 in Arkansas to $83.76 in Alaska. Washington, DC area pays $73.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99490 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 99490 in every payment locality

How the 99490 rate is calculated

Each of 99490’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.

Payment rules and modifiers for 99490

99490 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Codes related to 99490

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 99490 has changed in Washington, DC area

Price 99490 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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

Open CMS sourceHow we calculate rates