Billing code 99489: Complex chronic care managementMedicare rate & RVUs in Washington
Add-on for each additional 30 minutes of clinical staff complex chronic care management in a calendar month, beyond the first 60 minutes reported with 99487.
Medicare pays $80.28–$89.03 for 99489 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
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 9 sections
What 99489 covers
Complex chronic care management is a monthly, non-face-to-face service for patients with two or more chronic conditions expected to last at least 12 months or until death and posing significant risk of death, acute exacerbation, or functional decline. Clinical staff, such as nurses and medical assistants working under the direction of a physician or qualified health care professional, coordinate with specialists, home health agencies, and pharmacies, manage medications, educate patients and caregivers, and maintain the care plan. Primary care practices, geriatric clinics, and nephrology or cardiology groups managing high-needs patients are typical billers.
Code 99489 captures additional clinical staff time after the first 60 minutes reported with 99487 in the same calendar month. The first 99489 unit requires at least 90 total minutes; each further unit requires another 30 minutes. The primary service requires moderate or high complexity medical decision making and establishment or substantial revision of a comprehensive care plan. Document dated staff activities and cumulative time, patient consent, and the care plan. CMS classifies 99489 as an add-on, payable only with its primary service within that service's global period. Its practice expense RVUs are higher in the office than in a facility.
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 99489 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $80.28 | $44.06 |
| Seattle (King Cnty) | $89.03 | $46.82 |
How the 99489 rate is calculated
Each of 99489’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 · 99489
RVUs × geographic indexes × conversion factor
Work1.00
1.00 RVUs× 1.000 GPCI
Practice expense1.27
1.27 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
2.3400
Conversion factor
$33.4009
Medicare rate
$78.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99489
The CMS indicators that decide how 99489 is paid alongside other services.
CMS payment indicators · 99489
Complex 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. |
99489 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99439Chronic care management
- 99439 adds 20-minute increments to non-complex CCM with 99490; 99489 adds 30-minute increments to complex CCM with 99487, which requires moderate or high complexity decision making and establishment or substantial revision of a care plan.
- 99437Chronic care management
- 99437 counts the physician's or qualified health care professional's own additional time with 99491; 99489 counts additional clinical staff time with 99487.
- 99487Complex chronic care management
- 99487 covers the first 60 minutes of complex CCM clinical staff time in a month. Report the first 99489 unit with it when total time reaches 90 minutes.
99489 billing questions
Can 99489 be reported without 99487?
No. Report it with 99487 for the same patient's complex chronic care management in the same calendar month.
Can 99489 be reported with 99439 or 99490 in the same month?
No. Complex and non-complex chronic care management are not reported together for the same patient by the same practitioner in a calendar month.
Whose time counts toward 99489?
Count clinical staff time spent under the direction of the billing physician or qualified health care professional during the calendar month. Exclude time spent on separately reported services.
What documentation supports 99489?
Document dates, staff members, activities, and minutes for the month, along with patient consent, the comprehensive care plan and its establishment or substantial revision, and the moderate or high complexity medical decision making.
How are multiple units of 99489 reported?
Report the first unit with 99487 when total clinical staff time reaches 90 minutes in the calendar month. Each additional unit requires another 30 minutes.
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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