$63.79–$66.67
99490 is based on clinical staff CCM time under practitioner direction. 99491 requires the physician or qualified health care professional to personally furnish the counted time.
On this page
CMS RVU26D · Effective 2026-10-01
99491 Chronic care management Medicare reimbursement rates in Michigan
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. Compare 99491 office and facility rates across CMS payment localities in Michigan.
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 99491 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$86.43–$89.98
2 of 2 localities have a supported rate.
Facility setting
$64.78–$67.10
2 of 2 localities have a supported rate.
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.
Chronic care management
About 99491: Physician-led chronic care management
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.
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.
Where the value comes from
- Work RVU1.50 · 56%
- Practice expense (office) RVU1.08 · 40%
- Malpractice RVU0.09 · 3%
283.9K
Medicare services in 2024 · #325 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.
99491 compared with similar codes
Office rates for Michigan, from the same CMS release.
$137.94–$144.49
99487 is for complex CCM and uses its own complexity and clinical-staff time criteria. 99491 is based on at least 30 minutes personally furnished by a physician or qualified health care professional.
$55.59–$57.97
99484 describes behavioral health care management services. 99491 is the broader CCM pathway for patients who meet its chronic-condition criteria.
$210.41–$220.23
99495 addresses transitional care after discharge and includes a required face-to-face visit. 99491 reports qualifying monthly chronic care management.
Compare 99491 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
$89.98
Facility
$67.10
Rest Of Michigan →
Office / nonfacility
$86.43
Facility
$64.78
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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 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.
13,15299487,,Cplx chrnc care 1st 60 min,A,,1.81,2.38,,0.43,,0.13,4.32,2.37,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15399489,,Cplx chrnc care ea addl 30,A,,1.00,1.27,,0.24,,0.07,2.34,1.31,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15499490,,Chrnc care mgmt staff 1st 20,A,,1.00,0.91,,0.24,,0.07,1.98,1.31,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15599491,,Chrnc care mgmt phys 1st 30,A,,1.50,1.08,,0.37,,0.09,2.67,1.96,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15699492,,1st psyc collab care mgmt,A,,1.88,2.78,,0.44,,0.14,4.80,2.46,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15799493,,Sbsq psyc collab care mgmt,A,,2.05,2.15,,0.49,,0.14,4.34,2.68,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,15899494,,1st/sbsq psyc collab care,A,,0.82,0.96,,0.20,,0.06,1.84,1.08,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00