CPT 99490

CPT 99490 has been around since January 2015. However, many providers are still not able to take full advantage of this CPT code.

CPT 99490 refers to chronic care management program that enables medical practitioners to bill for the non face-to-face care coordination in between the office visit for Medicare beneficiaries. This non face-to-face care coordination includes all  activities performed to better prepare a medical practice to address the complexity of chronic conditions.

Billing Practitioner

Both primary care providers and specialist can bill CPT 99490. As per Medicare guidelines, a billing practitioner can provide the CCM services either by himself and through the clinical staff. However, these services can be outsourced the to a third party who will work under the direction of the billing practitioner.

Documentation Requirement

Medicare requires billing practitioners to use dedicated software and applications, capable to record and maintain the entire structured care coordination. This structured care coordination report should be accessible to all the parties including the billing practitioner, clinical teams, care coaches and any other party involved in the delivery of care.