$67.97
99490 represents recurring monthly CCM work. G0506 is for extensive assessment and care planning associated with a primary E/M service.
On this page
CMS RVU26D · Effective 2026-10-01
G0506 CCM care planning Medicare reimbursement rates in Colorado
Report G0506 when a physician or qualified health professional performs an extensive chronic care assessment and develops a care plan beyond the associated E/M service. Compare G0506 office and facility rates across CMS payment localities in Colorado.
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.
What does Medicare pay for G0506 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$68.64
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$38.79
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Care management
About G0506: Comprehensive CCM assessment and care plan
Report G0506 when a physician or qualified health professional performs an extensive chronic care assessment and develops a care plan beyond the associated E/M service.
G0506 represents in-depth assessment and care planning for a patient with chronic conditions who is starting chronic care management. A physician or other qualified health professional may review the patient’s health problems, medications, functional needs, and supports, then establish an individualized plan for ongoing care. The work goes beyond the assessment and planning ordinarily included in the associated evaluation and management service.
Report G0506 as an add-on with the primary E/M procedure; it is not a stand-alone service. The record should show the chronic care needs assessed, the planning performed, and how that work exceeded the routine E/M. CMS pays the add-on within the primary procedure’s global period. G0506 describes the comprehensive planning work, not the recurring monthly management service; report a monthly CCM code only when its own requirements are met.
CMS billing rules for G0506
- 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 RVU0.87 · 44%
- Practice expense (office) RVU1.06 · 53%
- Malpractice RVU0.06 · 3%
163.7K
Medicare services in 2024 · #427 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.
G0506 compared with similar codes
Office rates for Colorado, from the same CMS release.
$149.15
99487 describes monthly complex CCM management. G0506 describes comprehensive assessment and care planning, rather than the recurring monthly management service.
$91.43
99491 represents monthly CCM personally furnished by a physician or qualified health professional. G0506 is an add-on for comprehensive care planning with a primary E/M service.
Compare G0506 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$68.64
Facility
$38.79
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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 G0506 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
15,306
- Code
- G0506
- Physician work
- 0.87
- Practice expense
- 1.06
- Malpractice
- 0.06
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.87 | × 1.012 | 0.8804 |
| Practice expense | 1.06 | × 1.064 | 1.1278 |
| Malpractice | 0.06 | × 0.781 | 0.0469 |
| Total RVUs | 2.0551 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$68.64
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.87 | 1.012 |
| Practice expense | 1.06 | 1.064 |
| Malpractice | 0.06 | 0.781 |
(0.87 × 1.012 + 1.06 × 1.064 + 0.06 × 0.781) × $33.4009 = $68.64
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.87 | 1.012 |
| Practice expense | 0.22 | 1.064 |
| Malpractice | 0.06 | 0.781 |
(0.87 × 1.012 + 0.22 × 1.064 + 0.06 × 0.781) × $33.4009 = $38.79
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.
G0506 billing questions
When should G0506 be chosen instead of reporting only the E/M service?
Use it when the physician or qualified health professional performs extensive chronic care assessment and planning beyond the work ordinarily included in the E/M service. Routine discussion of chronic conditions during an office visit alone does not establish that additional work.
What primary service must accompany G0506?
G0506 is an add-on and must be reported with a primary E/M procedure. CMS pays it within that primary procedure’s global period.
Does G0506 represent the monthly CCM service?
No. It represents comprehensive assessment and care planning, not recurring monthly management. A monthly CCM code requires its own qualifying work and documentation.
What documentation supports G0506?
Document the chronic care needs assessed, the individualized planning performed, and why that work went beyond the associated E/M service. A care plan should reflect the patient’s conditions and care needs rather than a routine problem list alone.
Can G0506 be reported with an office E/M code?
Yes, it is reported as an add-on to a qualifying primary E/M service. Examples include office E/M codes 99214 and 99215; the record must support the additional comprehensive planning work.
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.
15,303G0499,,Hepb screen high risk indiv,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,304G0500,,Mod sedat endo service >5yrs,A,,0.10,1.86,,0.03,,0.03,1.99,0.16,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,305G0501,,Resource-inten svc during ov,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,306G0506,,Comp asses care plan ccm svc,A,,0.87,1.06,,0.22,,0.06,1.99,1.15,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,307G0508,,Crit care telehea consult 60,A,,4.00,1.17,NA,1.17,,0.36,5.53,5.53,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,308G0509,,Crit care telehea consult 50,A,,3.86,1.06,NA,1.06,,0.36,5.28,5.28,0,XXX,0.00,0.00,0.00,0,0,9,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,309G0513,,"Prolong prev svcs, first 30m",A,,1.17,0.70,,0.28,,0.07,1.94,1.52,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899