Considering the amount of time spent by the clinical staff on all non-face-to-face activities to better manage high risk Medicare populations in between their appointments, the initial billable code CPT 99490 for 20 mins clinical staff time was not sufficient. In order to bridge the gap and facilitate medical practitioner in providing managed care coordination, CMS has introduced a new add-on code in the 2020 Physician Fee Schedule.

G2058

G2058 is billable for an additional 20 minutes spent by clinical staff. The CCM add-on can be billed twice in a month along with CPT 99490 in a calendar month. This covers all additional activities performed by the clinical staff to manage patient health.

Additional Billable Activities

The additional activities range from any non face-to-face activity performed by the clinical staff with or without direct involvement of the patient. It includes telephonic or electronic communication with the patient or care giver, patient chart reviews, lab test order and review by the provider (s), prescription refills and updating patient records electronically.