CPT code 99491: Chronic care management, 30 minutes, physician/QHP time2026 Medicare rate & RVUs in Montana

Reports at least 30 minutes of chronic care management personally furnished by a physician or qualified health care professional for an eligible patient during a calendar month.

CMS RVU26DEffective Oct 1, 2026One payment locality283.9K Medicare services in 2024

In Montana, Medicare pays $89.17 for 99491 in the office and $65.46 when it’s performed in a hospital or facility.

$89.17Office (non-facility)
$65.46Hospital or facility
−0.0%vs the national office rate ($89.18)

Check a contract rate as a % of Medicare · 99491 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 99491 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 99491 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 99491 covers

This service coordinates ongoing care for a patient with at least two chronic conditions expected to last at least 12 months or until death, when those conditions create significant risk of exacerbation, decline, or loss of function. A physician or other qualified health care professional personally performs the care-management work, which may include updating the care plan, coordinating with other treating professionals, and managing medications. Work is generally performed outside a face-to-face visit and may address conditions such as diabetes, heart failure, or COPD.

Report 99491 when the physician or qualified health care professional personally furnishes at least 30 minutes of qualifying CCM work during the calendar month. Select it based on the personally furnished time, not the combined time of the whole care team; clinical staff minutes do not meet this code’s time threshold. Documentation should support the patient’s qualifying conditions, the care plan and coordination performed, and the practitioner’s time for the 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 Montana compares for 99491

Across 109 of 109 payment localities, the office rate for 99491 runs from $82.64 in Arkansas to $115.23 in Alaska. Montana pays $89.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

99491 in Montana vs other payment areas
  1. Montana · this page$89.17
  2. Los Angeles, CA · California$96.83+$7.66
  3. Washington, DC area · District of Columbia$98.65+$9.48
  4. Miami, FL · Florida$95.26+$6.09
  5. Chicago, IL · Illinois$93.60+$4.43
  6. Manhattan, NY · New York$99.99+$10.82
  7. Alaska · Alaska$115.23+$26.06

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

Every other payment area

99491 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$83.37$62.62
ArkansasArkansas$82.64$62.27
ArizonaArizona$87.63$64.65
Bakersfield, CACalifornia$92.42$66.43
Chico, CACalifornia$92.10$66.11
El Centro, CACalifornia$92.12$66.12
Fresno, CACalifornia$92.10$66.11
Hanford, CACalifornia$92.10$66.11

99491 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.

$82.64

$115.23

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

View every state and territory as a table
99491 office rate range by state
State / territoryOffice rate rangeLocalities
AK$115.231
AL$83.371
AR$82.641
AZ$87.631
CA$92.10–$109.2429
CO$91.431
CT$93.591
DC$98.651
DE$88.691
FL$89.11–$95.263
GA$85.86–$90.512
GU$92.861
HI$92.861
IA$84.301
ID$84.711
IL$87.73–$93.604
IN$85.001
KS$84.231
KY$84.921
LA$84.91–$87.462
MA$91.28–$97.902
MD$89.87–$98.653
ME$85.16–$87.752
MI$86.43–$89.982
MN$88.111
MO$84.12–$87.453
MS$83.381
MT$89.171
NC$85.681
ND$87.391
NE$84.531
NH$90.281
NJ$94.79–$98.312
NM$86.791
NV$88.711
NY$86.48–$101.785
OH$86.071
OK$84.651
OR$88.14–$93.222
PA$86.06–$92.142
PR$89.531
RI$91.001
SC$85.991
SD$87.181
TN$84.511
TX$85.72–$91.038
UT$86.711
VA$87.68–$98.652
VI$89.531
VT$87.331
WA$91.03–$99.322
WI$85.591
WV$85.751
WY$88.401

See 99491 in every payment locality

How the 99491 rate is calculated

Each of 99491’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 · 99491

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.50

1.50 RVUs× 1.000 GPCI

Practice expense1.08

1.08 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

2.6700

Conversion factor

$33.4009

Medicare rate

$89.18

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

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,155

Code
99491
Physician work
1.50
Practice expense
1.08
Malpractice
0.09

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 99491 in Montana
ComponentRVULocality factorAdjusted
Physician work1.50× 1.0001.5000
Practice expense1.08× 1.0001.0800
Malpractice0.09× 0.9980.0898
Total RVUs2.6698
Conversion factor× 33.4009

Office rate, Montana$89.17

Office: (1.5 × 1 + 1.08 × 1 + 0.09 × 0.998) × $33.4009 = $89.17

Facility: (1.5 × 1 + 0.37 × 1 + 0.09 × 0.998) × $33.4009 = $65.46

Open 99491 in the RVU calculator

Payment rules and modifiers for 99491

99491 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 · 99491

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$89.18

Non-facility (office)
$89.18
Facility
$65.47

Higher because the practice carries its own overhead.

How 99491 has changed in Montana

99491 · Office / nonfacility

$89.17

Effective 2026-10-01

The base rate is $7.08 higher than on 2025-10-01, moving from $82.09 to $89.17 (8.6%).

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

    $82.09changed to$89.17

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.94 changed to 1.08
    • Malpractice RVU 0.10 changed to 0.09
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $84.48changed to$82.09

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $83.10changed to$84.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $84.98changed to$83.10

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.91 changed to 0.94
  5. January 1, 2023

    RVU23A

    $86.09changed to$84.98

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.89 changed to 0.91
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $82.28changed to$86.09

    • Conversion factor 34.8931 changed to 34.6062
    • Work RVU 1.45 changed to 1.50
    • Practice expense RVU 0.82 changed to 0.89
    • Malpractice RVU 0.09 changed to 0.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $85.08changed to$82.28

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.79 changed to 0.82
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $86.02changed to$85.08

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    No ratechanged to$86.02

    Held through RVU19B, RVU19C, RVU19D.

  10. 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, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$89.17$65.46RVU26D
2026-07-01$89.17$65.46RVU26C
2026-04-01$89.17$65.46RVU26B
2026-01-01$89.17$65.46RVU26A
2025-10-01$82.09$72.38RVU25D
2025-07-01$82.09$72.38RVU25C
2025-04-01$82.09$72.38RVU25B
2025-01-01$82.09$72.38RVU25A
2024-10-01$84.48$74.49RVU24D
2024-07-01$84.48$74.49RVU24C
2024-04-01$84.48$74.49RVU24B
2024-03-09$84.48$74.49RVU24AR
2024-01-01$83.10$73.27RVU24A
2023-10-01$84.98$75.49RVU23D
2023-07-01$84.98$75.49RVU23C
2023-04-01$84.98$75.49RVU23B
2023-01-01$84.98$75.49RVU23A
2022-10-01$86.09$77.44RVU22D
2022-07-01$86.09$77.44RVU22C
2022-04-01$86.09$77.44RVU22B
2022-01-01$86.09$77.44RVU22A
2021-10-01$82.28$82.28RVU21D
2021-07-01$82.28$82.28RVU21C
2021-04-01$82.28$82.28RVU21B
2021-01-01$82.28$82.28RVU21A
2020-10-01$85.08$85.08RVU20D
2020-07-01$85.08$85.08RVU20C
2020-04-01$85.08$85.08RVU20B
2020-01-01$85.08$85.08RVU20A
2019-10-01$86.02$86.02RVU19D
2019-07-01$86.02$86.02RVU19C
2019-04-01$86.02$86.02RVU19B
2019-01-01$86.02$86.02RVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
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 99491 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

99491 billing questions

How is 99491 different from 99490?

99491 counts CCM time personally furnished by a physician or qualified health care professional. 99490 is the staff-time pathway, so choose based on who performed the documented work.

Can clinical staff minutes help reach the 30-minute threshold?

No. The threshold for 99491 is based on time personally furnished by the physician or qualified health care professional; staff time does not count toward it.

Is 99491 a face-to-face visit?

No. It reports monthly chronic care management work, which can include care planning and coordination outside a face-to-face encounter.

What should the record show?

Document the qualifying chronic conditions, the care plan and management activities, and a time record supporting at least 30 minutes personally furnished during the calendar month.

When would 99487 be a better fit?

Consider 99487 for complex chronic care management when its complexity and clinical-staff time criteria are met. 99491 is selected for qualifying physician or qualified health care professional time.

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 99491PPRRVU2026_Oct_nonQPP.csv, line 13,155 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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