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Chronic care CPT codes

Kathy Posted Mon 29th of April, 2019 10:31:14 AM
Can only Primary Care practices use Chronic Care codes CPT 99487, 99489.99490
SuperCoder Answered Tue 30th of April, 2019 08:04:02 AM

Hi Cathy,

It is not only Primary Care practices that can use chronic care codes 99487, 99489, 99490. However, as per the description of these codes that says “60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month”, In this case, the billing physician services are counted as clinical staff services.

According to CPT®, clinical staff implies those who work ‘under the supervision of the physician or qualified healthcare professional.’ This may include physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse midwives. If your billing physician provides the chronic care management services, you can count the time for code 99487.


Before you count the time of the clinical staff for the code 99487, make sure the service qualifies for Medicare’s ‘incident to’ criteria such as supervision by a physician and scope of practice. 

Feel free to ask for any further query. 

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