Billing code 99437: Chronic care managementMedicare rate & RVUs
Reports each additional 30 minutes of physician or qualified health care professional chronic care management performed during a calendar month.
Medicare pays $63.13 for 99437 nationally in the office and $43.76 in a hospital or facility. Local office rates run $58.13–$80.56.
Medicare rate · 99437
Chronic care management
Swap in your local Medicare rate.
- Work RVUs
- 1
- Total RVUs
- 1.89
- Global days
- ZZZ
National rate · 2026
$63.13
Office setting, before claim adjustments.
See every locality for 99437 → · Billed by an NP, PA or therapist? →
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 10 sections
What 99437 covers
Code 99437 captures an additional 30 minutes of chronic care management personally performed by a physician or other qualified health care professional during a calendar month. It supports ongoing coordination for a patient with multiple chronic conditions, such as coordinating a medication change with a specialist, updating the care plan, and following up on care transitions. The service is generally part of longitudinal outpatient management rather than a face-to-face visit, and the time must reflect qualifying work performed by the physician or qualified professional, not clinical staff time.
Report 99437 as an add-on to 99491, which accounts for the initial 30 minutes of physician or qualified professional chronic care management in the month. Documentation should identify the chronic care management activities, the responsible professional, and the time supporting each reported increment. Do not use it to count time already reported for another service or to represent staff-delivered chronic care management. CMS classifies it as an add-on code: it must be billed with its primary procedure, and payment is within that procedure's global period.
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.
Where 99437 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$58.13 to $80.56
109 of 109 payment localities
99437 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$58.13
$80.56
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 | $80.56 | 1 |
| AL | $58.69 | 1 |
| AR | $58.13 | 1 |
| AZ | $61.94 | 1 |
| CA | $65.24–$77.82 | 29 |
| CO | $64.77 | 1 |
| CT | $66.40 | 1 |
| DC | $70.07 | 1 |
| DE | $62.73 | 1 |
| FL | $63.10–$67.83 | 3 |
| GA | $60.62–$64.14 | 2 |
| GU | $65.90 | 1 |
| HI | $65.90 | 1 |
| IA | $59.39 | 1 |
| ID | $59.70 | 1 |
| IL | $62.06–$66.53 | 4 |
| IN | $59.93 | 1 |
| KS | $59.34 | 1 |
| KY | $59.89 | 1 |
| LA | $59.88–$61.83 | 2 |
| MA | $64.64–$69.55 | 2 |
| MD | $63.60–$70.07 | 3 |
| ME | $60.05–$62.02 | 2 |
| MI | $61.05–$63.77 | 2 |
| MN | $62.28 | 1 |
| MO | $59.29–$61.82 | 3 |
| MS | $58.71 | 1 |
| MT | $63.12 | 1 |
| NC | $60.45 | 1 |
| ND | $61.74 | 1 |
| NE | $59.56 | 1 |
| NH | $63.96 | 1 |
| NJ | $67.21–$69.77 | 2 |
| NM | $61.32 | 1 |
| NV | $62.76 | 1 |
| NY | $61.06–$72.45 | 5 |
| OH | $60.76 | 1 |
| OK | $59.68 | 1 |
| OR | $62.32–$66.10 | 2 |
| PA | $60.75–$65.30 | 2 |
| PR | $63.39 | 1 |
| RI | $64.41 | 1 |
| SC | $60.70 | 1 |
| SD | $61.58 | 1 |
| TN | $59.55 | 1 |
| TX | $60.50–$64.52 | 8 |
| UT | $61.25 | 1 |
| VA | $61.97–$70.07 | 2 |
| VI | $63.39 | 1 |
| VT | $61.70 | 1 |
| WA | $64.45–$70.59 | 2 |
| WI | $60.36 | 1 |
| WV | $60.55 | 1 |
| WY | $62.52 | 1 |
How the 99437 rate is calculated
Each of 99437’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 · 99437
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.00Practice expense 0.82Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99437
The CMS indicators that decide how 99437 is paid alongside other services.
CMS payment indicators · 99437
Chronic care management
| 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. |
99437 compared with similar codes
Compare codes
99437 vs 99491 vs 99439 vs 99425: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 99491Chronic care management
- 99491 accounts for the initial 30 minutes of physician or qualified professional chronic care management in the month. Use 99437 only for additional qualifying time with that primary code.
- 99439Chronic care management
- 99439 covers additional chronic care management time furnished by clinical staff under the 99490 pathway; 99437 is for physician or qualified professional time under the 99491 pathway.
- 99425Principal care management
- 99425 is additional physician principal care management time for a single complex chronic condition. 99437 adds time to broader chronic care management reported with 99491.
99437 billing questions
Which primary code is paired with 99437?
Pair 99437 with 99491, the physician or qualified health care professional code for the initial 30 minutes of chronic care management in the month.
Can 99437 report clinical staff time?
No. It represents additional time personally furnished by a physician or other qualified health care professional. Staff-delivered chronic care management uses a different code pathway.
How much time supports one unit?
Document each additional 30-minute increment of qualifying physician or qualified professional chronic care management performed during the calendar month.
How does 99437 differ from 99439?
99437 is for additional physician or qualified professional time in the 99491 pathway; 99439 is for additional clinical staff time in the 99490 pathway.
What documentation supports 99437?
Record the chronic care management work performed, the physician or qualified professional who performed it, and the time supporting the additional increment.
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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