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CCMBase2026 Compliant

CPT 99487

2026 Billing Guide

Complex CCM 60 min

Reimbursement

$144.29

Threshold

60m

2026 Status

Active

What is CPT Code 99487?

CPT 99487 is defined as: Complex chronic care management services, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; establishment or substantial revision of a comprehensive care plan; moderate or high complexity medical decision making; first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.

This code is primarily used for CCM services. It falls under the category of Care Management / Complex CCM and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

2.38

Physician Effort

PE (Non-Fac)

1.75

Practice Expense

Malpractice

0.19

Risk Factor

Total RVU

4.32

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

Protected from the -2.5% productivity adjustment (Time-based care management service).

high complexity premium

99487 pays significantly more ($103.54) than standard CCM ($61.96), rewarding the increased staff time and MDM complexity.

fqhc rhc transition

FQHCs must now itemize and bill 99487 for patients meeting complex CCM criteria to capture the true cost of care following G0511 sunset.

Administrative Framework

Place of Service

11 (Office)22 (Outpatient Hospital)

NCCI Exclusions

Do not bill with:99490994919942499426G0511

Key Modifiers

G2211Applicable to the office E/M visit establishing the complex care plan.

Operational Requirements

minimum time

60 minutes of cumulative clinical staff time per calendar month.

mdm level

Moderate or High Complexity Medical Decision Making (MDM) REQUIRED.

care plan

Establishment or SUBSTANTIAL revision of a comprehensive care plan.

frequency

Once per calendar month.

Compliance Checklist

Aggregate staff time log totaling 60+ minutes.
Documentation of the 'Substantial Revision' to the care plan.
MDM level justification in the physician's oversight note.

Audit Defense

mdm evidence

Audit failure often occurs if the physician note does not demonstrate moderate/high complexity decision making (e.g., managing multiple systemic treatments).

distinct from setup

Time spent on the initial E/M visit cannot count toward the 60-minute staff management time.

2026 Update

A 'substantial revision' typically involves a change in treatment modality, adding new specialist coordination, or responding to a recent hospitalization.

Common Clinical Scenarios

Patient with CHF and Stage 4 CKD requiring complex medication titration and weekly coordination between cardiology and nephrology.
Elderly patient with brittle Diabetes and Advanced Alzheimer's requiring intensive caregiver support and safety monitoring.
Oncology patient with metastatic disease and severe neuropathy requiring complex pain management and palliative coordination.

Target Specialties & Utilization

Internal MedicineNephrologyCardiologyGeriatrics

Typical Clinical Indications (ICD-10)

I50.9 (Heart failure)N18.4 (Stage 4 CKD)E11.65 (Complex Diabetes)G30.9 (Alzheimer's)

Frequently Asked Questions

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