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CMS RVU26D · Effective 2026-10-01

99437 in Merced

Office / nonfacility

$65.24

Base rate per service

Facility setting

$44.01

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 99437: Additional physician chronic care management

Reports each additional 30 minutes of physician or qualified health care professional chronic care management performed during a calendar month.

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.

CMS billing rules for 99437

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.

Where the value comes from

  • Work RVU1.00 · 53%
  • Practice expense (office) RVU0.82 · 43%
  • Malpractice RVU0.07 · 4%

31K

Medicare services in 2024 · #964 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.

99437 compared with similar codes

Office rates for Merced, from the same CMS release.

99491

Chronic care management

30 minutes, physician/QHP time

$92.10

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.

99439

Chronic care management

Clinical staff, each additional 20 minutes

$52.49

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.

99425

Principal care management

Each additional 30 minutes

$63.41

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.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 99437 is $65.48—$0.24 higher than the $65.24 rate in Merced. Both use the same code, release and participation basis.

99437 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $65.24

  2. Bakersfield

    $65.48

    $0.24 higher than Merced

  3. Chico

    $65.24

    The same base rate than Merced

  4. El Centro

    $65.25

    $0.01 higher than Merced

  5. Fresno

    $65.24

    The same base rate than Merced

  6. Hanford-Corcoran

    $65.24

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $68.72

    $3.48 higher than Merced

Other payment areas listed in California 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, 99437 ranges from $58.13 in Arkansas to $80.56 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

  • Madera

    California · 99437

    Office

    $65.24

    Facility

    $44.01

    The same base rate than Merced for the office setting.

  • Modesto

    California · 99437

    Office

    $65.24

    Facility

    $44.01

    The same base rate than Merced for the office setting.

  • Napa

    California · 99437

    Office

    $72.79

    Facility

    $47.26

    $7.55 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99437

    Office

    $68.17

    Facility

    $45.27

    $2.93 higher than Merced for the office setting.

  • Redding

    California · 99437

    Office

    $65.24

    Facility

    $44.01

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 99437

    Office

    $65.24

    Facility

    $44.01

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99437

    Office

    $66.01

    Facility

    $44.78

    $0.77 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99437

    Office

    $67.71

    Facility

    $45.18

    $2.47 higher than Merced for the office setting.

  • Salinas

    California · 99437

    Office

    $67.43

    Facility

    $44.98

    $2.19 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99437

    Office

    $68.43

    Facility

    $45.26

    $3.19 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99437

    Office

    $76.27

    Facility

    $48.95

    $11.03 higher than Merced for the office setting.

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

    California · 99437

    Office

    $76.19

    Facility

    $48.87

    $10.95 higher than Merced for the office setting.

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

    California · 99437

    Office

    $77.82

    Facility

    $49.89

    $12.58 higher than Merced for the office setting.

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

    California · 99437

    Office

    $77.50

    Facility

    $49.56

    $12.26 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99437

    Office

    $66.42

    Facility

    $44.35

    $1.18 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 99437

    Office

    $68.63

    Facility

    $45.10

    $3.39 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 99437

    Office

    $67.52

    Facility

    $44.94

    $2.28 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 99437

    Office

    $69.29

    Facility

    $45.50

    $4.05 higher than Merced for the office setting.

  • Stockton

    California · 99437

    Office

    $65.24

    Facility

    $44.01

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 99437

    Office

    $72.68

    Facility

    $47.14

    $7.44 higher than Merced for the office setting.

  • Visalia

    California · 99437

    Office

    $65.24

    Facility

    $44.01

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 99437

    Office

    $65.24

    Facility

    $44.01

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 99437

    Office

    $70.07

    Facility

    $47.25

    $4.83 higher than Merced for the office setting.

  • Miami

    Florida · 99437

    Office

    $67.83

    Facility

    $47.66

    $2.59 higher than Merced for the office setting.

  • Chicago

    Illinois · 99437

    Office

    $66.53

    Facility

    $47.06

    $1.29 higher than Merced for the office setting.

  • Manhattan

    New York · 99437

    Office

    $71.07

    Facility

    $48.56

    $5.83 higher than Merced for the office setting.

  • Alaska*

    Alaska · 99437

    Office

    $80.56

    Facility

    $59.93

    $15.32 higher than Merced for the office setting.

  • Alabama

    Alabama · 99437

    Office

    $58.69

    Facility

    $41.74

    $6.55 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 99437

    Office

    $58.13

    Facility

    $41.49

    $7.11 lower than Merced for the office setting.

  • Arizona

    Arizona · 99437

    Office

    $61.94

    Facility

    $43.17

    $3.30 lower than Merced for the office setting.

  • Colorado

    Colorado · 99437

    Office

    $64.77

    Facility

    $44.16

    $0.47 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 99437

    Office

    $66.40

    Facility

    $45.53

    $1.16 higher than Merced for the office setting.

  • Delaware

    Delaware · 99437

    Office

    $62.73

    Facility

    $43.59

    $2.51 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 99437

    Office

    $65.37

    Facility

    $45.75

    $0.13 higher than Merced for the office setting.

  • Rest Of Florida

    Florida · 99437

    Office

    $63.10

    Facility

    $44.58

    $2.14 lower than Merced for the office setting.

  • Atlanta

    Georgia · 99437

    Office

    $64.14

    Facility

    $44.45

    $1.10 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 99437

    Office

    $60.62

    Facility

    $43.34

    $4.62 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 99437

    Office

    $65.90

    Facility

    $43.87

    $0.66 higher than Merced for the office setting.

  • Iowa

    Iowa · 99437

    Office

    $59.39

    Facility

    $41.66

    $5.85 lower than Merced for the office setting.

  • Idaho

    Idaho · 99437

    Office

    $59.70

    Facility

    $41.88

    $5.54 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 99437

    Office

    $63.31

    Facility

    $45.48

    $1.93 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 99437

    Office

    $62.06

    Facility

    $44.37

    $3.18 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 99437

    Office

    $65.91

    Facility

    $46.01

    $0.67 higher than Merced for the office setting.

  • Indiana

    Indiana · 99437

    Office

    $59.93

    Facility

    $41.97

    $5.31 lower than Merced for the office setting.

  • Kansas

    Kansas · 99437

    Office

    $59.34

    Facility

    $41.83

    $5.90 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 99437

    Office

    $59.89

    Facility

    $42.67

    $5.35 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 99437

    Office

    $61.83

    Facility

    $43.60

    $3.41 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 99437

    Office

    $59.88

    Facility

    $42.74

    $5.36 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 99437

    Office

    $69.55

    Facility

    $46.42

    $4.31 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99437

    Office

    $64.64

    Facility

    $44.24

    $0.60 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99437

    Office

    $66.22

    Facility

    $45.43

    $0.98 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 99437

    Office

    $63.60

    Facility

    $43.99

    $1.64 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 99437

    Office

    $60.05

    Facility

    $42.23

    $5.19 lower than Merced for the office setting.

  • Southern Maine

    Maine · 99437

    Office

    $62.02

    Facility

    $42.82

    $3.22 lower than Merced for the office setting.

  • Detroit

    Michigan · 99437

    Office

    $63.77

    Facility

    $45.08

    $1.47 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 99437

    Office

    $61.05

    Facility

    $43.36

    $4.19 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 99437

    Office

    $62.28

    Facility

    $42.34

    $2.96 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 99437

    Office

    $61.40

    Facility

    $43.21

    $3.84 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 99437

    Office

    $61.82

    Facility

    $43.38

    $3.42 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 99437

    Office

    $59.29

    Facility

    $42.59

    $5.95 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 99437

    Office

    $58.71

    Facility

    $42.03

    $6.53 lower than Merced for the office setting.

  • Montana**

    Montana · 99437

    Office

    $63.12

    Facility

    $43.75

    $2.12 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 99437

    Office

    $60.45

    Facility

    $42.37

    $4.79 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 99437

    Office

    $61.74

    Facility

    $42.37

    $3.50 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 99437

    Office

    $59.56

    Facility

    $41.68

    $5.68 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 99437

    Office

    $63.96

    Facility

    $43.79

    $1.28 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 99437

    Office

    $69.77

    Facility

    $47.30

    $4.53 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 99437

    Office

    $67.21

    Facility

    $46.06

    $1.97 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 99437

    Office

    $61.32

    Facility

    $43.56

    $3.92 lower than Merced for the office setting.

  • Nevada**

    Nevada · 99437

    Office

    $62.76

    Facility

    $43.37

    $2.48 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99437

    Office

    $72.45

    Facility

    $49.41

    $7.21 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99437

    Office

    $67.72

    Facility

    $46.51

    $2.48 higher than Merced for the office setting.

  • Queens

    New York · 99437

    Office

    $71.28

    Facility

    $48.39

    $6.04 higher than Merced for the office setting.

  • Rest Of New York

    New York · 99437

    Office

    $61.06

    Facility

    $42.66

    $4.18 lower than Merced for the office setting.

  • Ohio

    Ohio · 99437

    Office

    $60.76

    Facility

    $43.08

    $4.48 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 99437

    Office

    $59.68

    Facility

    $42.38

    $5.56 lower than Merced for the office setting.

  • Portland

    Oregon · 99437

    Office

    $66.10

    Facility

    $44.58

    $0.86 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 99437

    Office

    $62.32

    Facility

    $43.03

    $2.92 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99437

    Office

    $65.30

    Facility

    $45.14

    $0.06 higher than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99437

    Office

    $60.75

    Facility

    $42.97

    $4.49 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 99437

    Office

    $63.39

    Facility

    $43.81

    $1.85 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 99437

    Office

    $64.41

    Facility

    $44.40

    $0.83 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 99437

    Office

    $60.70

    Facility

    $42.80

    $4.54 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 99437

    Office

    $61.58

    Facility

    $42.20

    $3.66 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 99437

    Office

    $59.55

    Facility

    $41.94

    $5.69 lower than Merced for the office setting.

  • Austin

    Texas · 99437

    Office

    $64.52

    Facility

    $44.02

    $0.72 lower than Merced for the office setting.

  • Beaumont

    Texas · 99437

    Office

    $60.50

    Facility

    $42.87

    $4.74 lower than Merced for the office setting.

  • Brazoria

    Texas · 99437

    Office

    $62.63

    Facility

    $43.44

    $2.61 lower than Merced for the office setting.

  • Dallas

    Texas · 99437

    Office

    $62.99

    Facility

    $43.69

    $2.25 lower than Merced for the office setting.

  • Fort Worth

    Texas · 99437

    Office

    $62.74

    Facility

    $43.64

    $2.50 lower than Merced for the office setting.

  • Galveston

    Texas · 99437

    Office

    $62.80

    Facility

    $43.56

    $2.44 lower than Merced for the office setting.

  • Houston

    Texas · 99437

    Office

    $64.08

    Facility

    $44.85

    $1.16 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 99437

    Office

    $61.50

    Facility

    $43.12

    $3.74 lower than Merced for the office setting.

  • Utah

    Utah · 99437

    Office

    $61.25

    Facility

    $43.04

    $3.99 lower than Merced for the office setting.

  • Virginia

    Virginia · 99437

    Office

    $61.97

    Facility

    $42.93

    $3.27 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99437

    Office

    $63.39

    Facility

    $43.81

    $1.85 lower than Merced for the office setting.

  • Vermont

    Vermont · 99437

    Office

    $61.70

    Facility

    $42.52

    $3.54 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 99437

    Office

    $64.45

    Facility

    $44.06

    $0.79 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 99437

    Office

    $70.59

    Facility

    $46.82

    $5.35 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 99437

    Office

    $60.36

    Facility

    $41.80

    $4.88 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 99437

    Office

    $60.55

    Facility

    $43.71

    $4.69 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 99437

    Office

    $62.52

    Facility

    $43.15

    $2.72 lower than Merced for the office setting.

See how rates vary across the country

99437 · 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.

$58.13

$80.56

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$80.561
AL$58.691
AR$58.131
AZ$61.941
CA$65.24–$77.8229
CO$64.771
CT$66.401
DC$70.071
DE$62.731
FL$63.10–$67.833
GA$60.62–$64.142
GU$65.901
HI$65.901
IA$59.391
ID$59.701
IL$62.06–$66.534
IN$59.931
KS$59.341
KY$59.891
LA$59.88–$61.832
MA$64.64–$69.552
MD$63.60–$70.073
ME$60.05–$62.022
MI$61.05–$63.772
MN$62.281
MO$59.29–$61.823
MS$58.711
MT$63.121
NC$60.451
ND$61.741
NE$59.561
NH$63.961
NJ$67.21–$69.772
NM$61.321
NV$62.761
NY$61.06–$72.455
OH$60.761
OK$59.681
OR$62.32–$66.102
PA$60.75–$65.302
PR$63.391
RI$64.411
SC$60.701
SD$61.581
TN$59.551
TX$60.50–$64.528
UT$61.251
VA$61.97–$70.072
VI$63.391
VT$61.701
WA$64.45–$70.592
WI$60.361
WV$60.551
WY$62.521

Explore 99437 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, 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 California →

Why are the office and facility amounts different?

For 99437 in Merced, the physician’s office rate is $65.24 and the facility-setting rate is $44.01: a difference of $21.23.

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 99437 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$71.76

$65.24 × 110% = $71.76

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 99437 in Merced.

PPRRVU2026_Oct_nonQPP.csv

13,110

Code
99437
Physician work
1.00
Practice expense
0.82
Malpractice
0.07

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 99437 in Merced
ComponentRVULocality factorAdjusted
Physician work1.00× 1.0171.0170
Practice expense0.82× 1.0960.8987
Malpractice0.07× 0.5360.0375
Total RVUs1.9532
Conversion factor× 33.4009

Office / nonfacility rate, Merced$65.24

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

Open 99437 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work11.017
Practice expense0.821.096
Malpractice0.070.536

(1 × 1.017 + 0.82 × 1.096 + 0.07 × 0.536) × $33.4009 = $65.24

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work11.017
Practice expense0.241.096
Malpractice0.070.536

(1 × 1.017 + 0.24 × 1.096 + 0.07 × 0.536) × $33.4009 = $44.01

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

99437 · Office / nonfacility

$65.24

Effective 2026-10-01

The base rate is $5.90 higher than on 2025-10-01, moving from $59.34 to $65.24 (9.9%).

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

    $59.34changed to$65.24

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.72 changed to 0.82
    • Malpractice RVU 0.06 changed to 0.07
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $59.34

    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$65.24$44.01RVU26D
2026-07-01$65.24$44.01RVU26C
2026-04-01$65.24$44.01RVU26B
2026-01-01$65.24$44.01RVU26A
2025-10-01$59.34$48.74RVU25D
2025-07-01$59.34$48.74RVU25C
2025-04-01$59.34$48.74RVU25B
2025-01-01$59.34$48.74RVU25A

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 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 99437PPRRVU2026_Oct_nonQPP.csv, line 13,110 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet