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CMS RVU26D · Effective 2026-10-01

99490 in Austin

Office / nonfacility

$67.70

Base rate per service

Facility setting

$44.02

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Care management

About 99490: Chronic care management, clinical staff first 20 minutes

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

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.

Where the value comes from

  • Work RVU1.00 · 51%
  • Practice expense (office) RVU0.91 · 46%
  • Malpractice RVU0.07 · 4%

6.9M

Medicare services in 2024 · #29 by national volume

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.

99490 compared with similar codes

Office rates for Austin, from the same CMS release.

99491

Chronic care management

30 minutes, physician/QHP time

$91.03

Choose 99491 for at least 30 minutes of CCM personally performed by the physician or qualified health care professional; 99490 is based on at least 20 minutes of directed clinical staff time.

99487

Complex chronic care management

Clinical staff, first 60 minutes

$148.53

99487 requires at least 60 minutes of staff time, moderate or high complexity medical decision making, and establishment or substantial revision of the comprehensive care plan. Use 99490 when its requirements are met instead.

99424

Principal care management

Physician/QHP, first 30 minutes

$89.24

99424 is based on physician or qualified health care professional time managing one qualifying high-risk chronic condition. 99490 requires clinical staff time managing at least two qualifying chronic conditions.

99484

Behavioral health management

General integration service

$58.70

99484 covers general behavioral health integration for a behavioral health condition. 99490 covers comprehensive care management for at least two qualifying chronic conditions, which may include behavioral health conditions.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 99490 is $63.23—$4.47 lower than the $67.70 rate in Austin. Both use the same code, release and participation basis.

99490 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $67.70

  2. Beaumont

    $63.23

    $4.47 lower than Austin

  3. Brazoria

    $65.61

    $2.09 lower than Austin

  4. Dallas

    $65.98

    $1.72 lower than Austin

  5. Fort Worth

    $65.71

    $1.99 lower than Austin

  6. Galveston

    $65.79

    $1.91 lower than Austin

  7. Houston

    $67.07

    $0.63 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 99490 ranges from $60.71 in Arkansas to $83.76 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 99490

    Office

    $64.36

    Facility

    $43.12

    $3.34 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 99490

    Office

    $72.28

    Facility

    $45.81

    $4.58 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 99490

    Office

    $73.61

    Facility

    $47.25

    $5.91 higher than Austin for the office setting.

  • Miami

    Florida · 99490

    Office

    $70.95

    Facility

    $47.66

    $3.25 higher than Austin for the office setting.

  • Chicago

    Illinois · 99490

    Office

    $69.55

    Facility

    $47.06

    $1.85 higher than Austin for the office setting.

  • Manhattan

    New York · 99490

    Office

    $74.57

    Facility

    $48.56

    $6.87 higher than Austin for the office setting.

  • Alaska*

    Alaska · 99490

    Office

    $83.76

    Facility

    $59.93

    $16.06 higher than Austin for the office setting.

  • Alabama

    Alabama · 99490

    Office

    $61.32

    Facility

    $41.74

    $6.38 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 99490

    Office

    $60.71

    Facility

    $41.49

    $6.99 lower than Austin for the office setting.

  • Arizona

    Arizona · 99490

    Office

    $64.85

    Facility

    $43.17

    $2.85 lower than Austin for the office setting.

  • Bakersfield

    California · 99490

    Office

    $68.77

    Facility

    $44.25

    $1.07 higher than Austin for the office setting.

  • Chico

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • El Centro

    California · 99490

    Office

    $68.55

    Facility

    $44.02

    $0.85 higher than Austin for the office setting.

  • Fresno

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Madera

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Merced

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Modesto

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Napa

    California · 99490

    Office

    $76.75

    Facility

    $47.26

    $9.05 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99490

    Office

    $71.72

    Facility

    $45.27

    $4.02 higher than Austin for the office setting.

  • Redding

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Rest Of California

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99490

    Office

    $69.31

    Facility

    $44.78

    $1.61 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99490

    Office

    $71.21

    Facility

    $45.18

    $3.51 higher than Austin for the office setting.

  • Salinas

    California · 99490

    Office

    $70.92

    Facility

    $44.98

    $3.22 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99490

    Office

    $72.02

    Facility

    $45.26

    $4.32 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99490

    Office

    $80.50

    Facility

    $48.95

    $12.80 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 99490

    Office

    $80.42

    Facility

    $48.87

    $12.72 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 99490

    Office

    $82.16

    Facility

    $49.89

    $14.46 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 99490

    Office

    $81.83

    Facility

    $49.56

    $14.13 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99490

    Office

    $69.84

    Facility

    $44.35

    $2.14 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 99490

    Office

    $72.29

    Facility

    $45.10

    $4.59 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 99490

    Office

    $71.03

    Facility

    $44.94

    $3.33 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 99490

    Office

    $72.98

    Facility

    $45.50

    $5.28 higher than Austin for the office setting.

  • Stockton

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Vallejo

    California · 99490

    Office

    $76.64

    Facility

    $47.14

    $8.94 higher than Austin for the office setting.

  • Visalia

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Yuba City

    California · 99490

    Office

    $68.53

    Facility

    $44.01

    $0.83 higher than Austin for the office setting.

  • Colorado

    Colorado · 99490

    Office

    $67.97

    Facility

    $44.16

    $0.27 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 99490

    Office

    $69.63

    Facility

    $45.53

    $1.93 higher than Austin for the office setting.

  • Delaware

    Delaware · 99490

    Office

    $65.70

    Facility

    $43.59

    $2.00 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 99490

    Office

    $68.42

    Facility

    $45.75

    $0.72 higher than Austin for the office setting.

  • Rest Of Florida

    Florida · 99490

    Office

    $65.97

    Facility

    $44.58

    $1.73 lower than Austin for the office setting.

  • Atlanta

    Georgia · 99490

    Office

    $67.19

    Facility

    $44.45

    $0.51 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 99490

    Office

    $63.30

    Facility

    $43.34

    $4.40 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 99490

    Office

    $69.31

    Facility

    $43.87

    $1.61 higher than Austin for the office setting.

  • Iowa

    Iowa · 99490

    Office

    $62.14

    Facility

    $41.66

    $5.56 lower than Austin for the office setting.

  • Idaho

    Idaho · 99490

    Office

    $62.47

    Facility

    $41.88

    $5.23 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 99490

    Office

    $66.07

    Facility

    $45.48

    $1.63 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 99490

    Office

    $64.81

    Facility

    $44.37

    $2.89 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 99490

    Office

    $68.99

    Facility

    $46.01

    $1.29 higher than Austin for the office setting.

  • Indiana

    Indiana · 99490

    Office

    $62.71

    Facility

    $41.97

    $4.99 lower than Austin for the office setting.

  • Kansas

    Kansas · 99490

    Office

    $62.06

    Facility

    $41.83

    $5.64 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 99490

    Office

    $62.56

    Facility

    $42.67

    $5.14 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 99490

    Office

    $64.66

    Facility

    $43.60

    $3.04 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 99490

    Office

    $62.54

    Facility

    $42.74

    $5.16 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 99490

    Office

    $73.14

    Facility

    $46.42

    $5.44 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99490

    Office

    $67.80

    Facility

    $44.24

    $0.10 higher than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99490

    Office

    $69.44

    Facility

    $45.43

    $1.74 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 99490

    Office

    $66.64

    Facility

    $43.99

    $1.06 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 99490

    Office

    $62.82

    Facility

    $42.23

    $4.88 lower than Austin for the office setting.

  • Southern Maine

    Maine · 99490

    Office

    $65.00

    Facility

    $42.82

    $2.70 lower than Austin for the office setting.

  • Detroit

    Michigan · 99490

    Office

    $66.67

    Facility

    $45.08

    $1.03 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 99490

    Office

    $63.79

    Facility

    $43.36

    $3.91 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 99490

    Office

    $65.37

    Facility

    $42.34

    $2.33 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 99490

    Office

    $64.23

    Facility

    $43.21

    $3.47 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 99490

    Office

    $64.68

    Facility

    $43.38

    $3.02 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 99490

    Office

    $61.88

    Facility

    $42.59

    $5.82 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 99490

    Office

    $61.30

    Facility

    $42.03

    $6.40 lower than Austin for the office setting.

  • Montana**

    Montana · 99490

    Office

    $66.13

    Facility

    $43.75

    $1.57 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 99490

    Office

    $63.25

    Facility

    $42.37

    $4.45 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 99490

    Office

    $64.74

    Facility

    $42.37

    $2.96 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 99490

    Office

    $62.34

    Facility

    $41.68

    $5.36 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 99490

    Office

    $67.09

    Facility

    $43.79

    $0.61 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 99490

    Office

    $73.26

    Facility

    $47.30

    $5.56 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 99490

    Office

    $70.49

    Facility

    $46.06

    $2.79 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 99490

    Office

    $64.08

    Facility

    $43.56

    $3.62 lower than Austin for the office setting.

  • Nevada**

    Nevada · 99490

    Office

    $65.77

    Facility

    $43.37

    $1.93 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99490

    Office

    $76.02

    Facility

    $49.41

    $8.32 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99490

    Office

    $71.02

    Facility

    $46.51

    $3.32 higher than Austin for the office setting.

  • Queens

    New York · 99490

    Office

    $74.84

    Facility

    $48.39

    $7.14 higher than Austin for the office setting.

  • Rest Of New York

    New York · 99490

    Office

    $63.92

    Facility

    $42.66

    $3.78 lower than Austin for the office setting.

  • Ohio

    Ohio · 99490

    Office

    $63.51

    Facility

    $43.08

    $4.19 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 99490

    Office

    $62.36

    Facility

    $42.38

    $5.34 lower than Austin for the office setting.

  • Portland

    Oregon · 99490

    Office

    $69.44

    Facility

    $44.58

    $1.74 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 99490

    Office

    $65.32

    Facility

    $43.03

    $2.38 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99490

    Office

    $68.43

    Facility

    $45.14

    $0.73 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99490

    Office

    $63.51

    Facility

    $42.97

    $4.19 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 99490

    Office

    $66.43

    Facility

    $43.81

    $1.27 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 99490

    Office

    $67.52

    Facility

    $44.40

    $0.18 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 99490

    Office

    $63.47

    Facility

    $42.80

    $4.23 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 99490

    Office

    $64.58

    Facility

    $42.20

    $3.12 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 99490

    Office

    $62.29

    Facility

    $41.94

    $5.41 lower than Austin for the office setting.

  • Utah

    Utah · 99490

    Office

    $64.07

    Facility

    $43.04

    $3.63 lower than Austin for the office setting.

  • Virginia

    Virginia · 99490

    Office

    $64.93

    Facility

    $42.93

    $2.77 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99490

    Office

    $66.43

    Facility

    $43.81

    $1.27 lower than Austin for the office setting.

  • Vermont

    Vermont · 99490

    Office

    $64.67

    Facility

    $42.52

    $3.03 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 99490

    Office

    $67.62

    Facility

    $44.06

    $0.08 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 99490

    Office

    $74.28

    Facility

    $46.82

    $6.58 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 99490

    Office

    $63.24

    Facility

    $41.80

    $4.46 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 99490

    Office

    $63.16

    Facility

    $43.71

    $4.54 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 99490

    Office

    $65.53

    Facility

    $43.15

    $2.17 lower than Austin for the office setting.

See how rates vary across the country

99490 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 all state and territory rates as a table
State / territoryRate 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

Explore 99490 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 99490 in Austin, the physician’s office rate is $67.70 and the facility-setting rate is $44.02: a difference of $23.68.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 99490 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$74.47

$67.70 × 110% = $74.47

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99490 in Austin.

PPRRVU2026_Oct_nonQPP.csv

13,154

Code
99490
Physician work
1.00
Practice expense
0.91
Malpractice
0.07

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 99490 in Austin
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0021.0020
Practice expense0.91× 1.0580.9628
Malpractice0.07× 0.8860.0620
Total RVUs2.0268
Conversion factor× 33.4009

Office / nonfacility rate, Austin$67.70

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 99490 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work11.002
Practice expense0.911.058
Malpractice0.070.886

(1 × 1.002 + 0.91 × 1.058 + 0.07 × 0.886) × $33.4009 = $67.70

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work11.002
Practice expense0.241.058
Malpractice0.070.886

(1 × 1.002 + 0.24 × 1.058 + 0.07 × 0.886) × $33.4009 = $44.02

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

99490 · Office / nonfacility

$67.70

Effective 2026-10-01

The base rate is $6.17 higher than on 2025-10-01, moving from $61.53 to $67.70 (10.0%).

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

    $61.53changed to$67.70

    • 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
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $61.53

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$67.70$44.02RVU26D
2026-07-01$67.70$44.02RVU26C
2026-04-01$67.70$44.02RVU26B
2026-01-01$67.70$44.02RVU26A
2025-10-01$61.53$48.33RVU25D
2025-07-01$61.53$48.33RVU25C
2025-04-01$61.53$48.33RVU25B
2025-01-01$61.53$48.33RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 99490PPRRVU2026_Oct_nonQPP.csv, line 13,154 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet