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

Monthly clinical staff care management for patients with at least two qualifying chronic conditions, reported after 20 minutes in a calendar month.

CMS RVU26DEffective Oct 1, 2026One payment locality6.9M Medicare services in 2024

In Wyoming, Medicare pays $65.53 for 99490 in the office and $43.15 when it’s performed in a hospital or facility.

$65.53Office (non-facility)
$43.15Hospital or facility
−0.9%vs the national office rate ($66.13)

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.

We’ll open 99490 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Wyoming
  2. What 99490 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Wyoming 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. Wyoming pays $65.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

99490 in Wyoming vs other payment areas
  1. Wyoming · this page$65.53
  2. Los Angeles, CA · California$72.28+$6.75
  3. Washington, DC area · District of Columbia$73.61+$8.08
  4. Miami, FL · Florida$70.95+$5.42
  5. Chicago, IL · Illinois$69.55+$4.02
  6. Manhattan, NY · New York$74.57+$9.04
  7. Alaska · Alaska$83.76+$18.23

Other areas in Wyoming first, then benchmark localities. Bars start at $0.

Every other payment area

99490 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$61.32$41.74
ArkansasArkansas$60.71$41.49
ArizonaArizona$64.85$43.17
Bakersfield, CACalifornia$68.77$44.25
Chico, CACalifornia$68.53$44.01
El Centro, CACalifornia$68.55$44.02
Fresno, CACalifornia$68.53$44.01
Hanford, CACalifornia$68.53$44.01

99490 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.

$60.71

$83.76

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99490 office rate range by state
State / territoryOffice rate rangeLocalities
AK$83.761
AL$61.321
AR$60.711
AZ$64.851
CA$68.53–$82.1629
CO$67.971
CT$69.631
DC$73.611
DE$65.701
FL$65.97–$70.953
GA$63.30–$67.192
GU$69.311
HI$69.311
IA$62.141
ID$62.471
IL$64.81–$69.554
IN$62.711
KS$62.061
KY$62.561
LA$62.54–$64.662
MA$67.80–$73.142
MD$66.64–$73.613
ME$62.82–$65.002
MI$63.79–$66.672
MN$65.371
MO$61.88–$64.683
MS$61.301
MT$66.131
NC$63.251
ND$64.741
NE$62.341
NH$67.091
NJ$70.49–$73.262
NM$64.081
NV$65.771
NY$63.92–$76.025
OH$63.511
OK$62.361
OR$65.32–$69.442
PA$63.51–$68.432
PR$66.431
RI$67.521
SC$63.471
SD$64.581
TN$62.291
TX$63.23–$67.708
UT$64.071
VA$64.93–$73.612
VI$66.431
VT$64.671
WA$67.62–$74.282
WI$63.241
WV$63.161
WY$65.531

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.

How the rate is built · 99490

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.00

1.00 RVUs× 1.000 GPCI

Practice expense0.91

0.91 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

1.9800

Conversion factor

$33.4009

Medicare rate

$66.13

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Wyoming inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,154

Code
99490
Physician work
1.00
Practice expense
0.91
Malpractice
0.07

GPCI2026.csv

112

Locality
Wyoming
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office calculation for 99490 in Wyoming
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0001.0000
Practice expense0.91× 1.0000.9100
Malpractice0.07× 0.7400.0518
Total RVUs1.9618
Conversion factor× 33.4009

Office rate, Wyoming$65.53

Office: (1 × 1 + 0.91 × 1 + 0.07 × 0.74) × $33.4009 = $65.53

Facility: (1 × 1 + 0.24 × 1 + 0.07 × 0.74) × $33.4009 = $43.15

Open 99490 in the RVU calculator

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.

Place of service · 99490

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$66.13

Non-facility (office)
$66.13
Facility
$43.76

Higher because the practice carries its own overhead.

How 99490 has changed in Wyoming

99490 · Office / nonfacility

$65.53

Effective 2026-10-01

The base rate is $5.55 higher than on 2025-10-01, moving from $59.98 to $65.53 (9.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $59.98changed to$65.53

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.81 changed to 0.91
    • Malpractice RVU 0.06 changed to 0.07
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $61.97changed to$59.98

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.07 changed to 0.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $60.96changed to$61.97

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $62.19changed to$60.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.78 changed to 0.81
    • Malpractice GPCI 0.790 changed to 0.739
  5. January 1, 2023

    RVU23A

    $63.64changed to$62.19

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice GPCI 0.841 changed to 0.790

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $40.95changed to$63.64

    • Conversion factor 34.8931 changed to 34.6062
    • Work RVU 0.61 changed to 1.00
    • Practice expense RVU 0.53 changed to 0.78
    • Malpractice RVU 0.04 changed to 0.07

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $41.97changed to$40.95

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.51 changed to 0.53
    • Malpractice RVU 0.05 changed to 0.04
    • Malpractice GPCI 0.860 changed to 0.841

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $41.99changed to$41.97

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.52 changed to 0.51
    • Malpractice RVU 0.04 changed to 0.05
    • Malpractice GPCI 0.880 changed to 0.860

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $42.67changed to$41.99

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.54 changed to 0.52

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $42.78changed to$42.67

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 1.050 changed to 0.880

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $41.13changed to$42.78

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.49 changed to 0.54
    • Malpractice GPCI 1.219 changed to 1.050

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $43.51changed to$41.13

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.54 changed to 0.49
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $43.30changed to$43.51

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    No ratechanged to$43.30

    Held through RVU15B.

  15. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$65.53$43.15RVU26D
2026-07-01$65.53$43.15RVU26C
2026-04-01$65.53$43.15RVU26B
2026-01-01$65.53$43.15RVU26A
2025-10-01$59.98$47.37RVU25D
2025-07-01$59.98$47.37RVU25C
2025-04-01$59.98$47.37RVU25B
2025-01-01$59.98$47.37RVU25A
2024-10-01$61.97$48.99RVU24D
2024-07-01$61.97$48.99RVU24C
2024-04-01$61.97$48.99RVU24B
2024-03-09$61.97$48.99RVU24AR
2024-01-01$60.96$48.19RVU24A
2023-10-01$62.19$49.99RVU23D
2023-07-01$62.19$49.99RVU23C
2023-04-01$62.19$49.99RVU23B
2023-01-01$62.19$49.99RVU23A
2022-10-01$63.64$51.18RVU22D
2022-07-01$63.64$51.18RVU22C
2022-04-01$63.64$51.18RVU22B
2022-01-01$63.64$51.18RVU22A
2021-10-01$40.95$31.53RVU21D
2021-07-01$40.95$31.53RVU21C
2021-04-01$40.95$31.53RVU21B
2021-01-01$40.95$31.53RVU21A
2020-10-01$41.97$32.59RVU20D
2020-07-01$41.97$32.59RVU20C
2020-04-01$41.97$32.59RVU20B
2020-01-01$41.97$32.59RVU20A
2019-10-01$41.99$32.26RVU19D
2019-07-01$41.99$32.26RVU19C
2019-04-01$41.99$32.26RVU19B
2019-01-01$41.99$32.26RVU19A
2018-10-01$42.67$32.59RVU18D
2018-07-01$42.67$32.59RVU18C
2018-04-01$42.67$32.59RVU18B
2018-01-01$42.67$32.59RVU18AR1
2017-10-01$42.78$32.73RVU17D
2017-07-01$42.78$32.73RVU17C
2017-04-01$42.78$32.73RVU17B
2017-01-01$42.78$32.73RVU17A
2016-10-01$41.13$31.82RVU16D
2016-07-01$41.13$31.82RVU16C
2016-04-01$41.13$31.82RVU16B
2016-01-01$41.13$31.82RVU16A
2015-10-01$43.51$33.45RVU15D
2015-07-01$43.51$33.45RVU15C
2015-04-01$43.30$33.29RVU15B
2015-01-01$43.30$33.29RVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99490 for an earlier date of service

Where the Wyoming rate applies

Wyoming is a Medicare payment area, not a city. Our Census mapping connects it to 205 cities and communities in Wyoming. Some span more than one payment area; confirm with the service ZIP.

  • Afton
  • Albany
  • Albin
  • Alcova
  • Alpine
  • Alpine Northeast
  • Alpine Northwest
  • Alta

Browse all communities in Wyoming

99490 billing questions

How does 99490 differ from 99491?

99490 counts clinical staff time directed by the billing practitioner, with a 20-minute threshold. 99491 requires at least 30 minutes personally spent by the physician or qualified health care professional.

Can 99490 and 99487 be billed in the same month?

No. Complex CCM under 99487 requires at least 60 minutes of staff time, moderate or high complexity medical decision making, and establishment or substantial revision of the care plan. Report the code supported by that month's work.

How is time beyond the first 20 minutes reported?

Report 99439 with 99490 for each additional full 20 minutes of clinical staff time in the calendar month. The first additional unit requires at least 40 total minutes.

What consent documentation is needed?

Record that the patient agreed, verbally or in writing, to receive CCM and was informed about cost sharing and the right to stop the service. Obtain consent before the first billed month.

Can 99490 be billed with transitional care management?

Yes. CCM and transitional care management under 99495 or 99496 may be reported for the same month when each service's requirements are met. Do not count the same minutes toward both.

Does face-to-face visit time count toward the 20 minutes?

Do not count time spent furnishing a separately billed E/M visit. Count documented clinical staff time spent on qualifying CCM activities, whether those activities occur in person or remotely.

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
RVUs for 99490PPRRVU2026_Oct_nonQPP.csv, line 13,154 (RVU26D)
Geographic factors for WyomingGPCI2026.csv, line 112 (RVU26D)

Open CMS sourceHow we calculate rates

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