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The 2026 CPT Codes for Chronic Care Management, or CCM, are here! This year, there are some very exciting increases to the CCM reimbursement rates. In this video, we'll break down everything that you need to know to successfully code and bill for CCM in 2026.
2026 Final Rule Updates to Chronic Care Management
This year, there are no major changes to the CCM program in CMS’s Final Rule for 2026, but there has been a 10% increase in reimbursements from CMS for all CCM codes. With the increase in reimbursement rates, CMS is incentivizing increased utilization of the program. Now is a great time for groups to grow or start a CCM program.
Remember that the rates are based on national averages, which may vary in your area. Visit the Physician Fee Schedule website for the exact current rate based on your location.
Chronic Care Management Code Series
Chronic Care Management is broken up into three series of codes:
- Non-complex CCM
- Complex CCM
- Physician-driven CCM
Non-Complex CCM Codes
The first code is 99490 for 20 minutes of non-face-to-face CCM services done by clinical staff. The current national average reimbursement is about $66.
Next, is the add-on code 99439. This is for an additional 20 minutes of CCM services done by clinical staff. It has a national average reimbursement of $50. This code can be billed up to two times per month, so at 40 minutes and 60 minutes.
Complex CCM Codes
These are billed for patients who may need more care than others, or have more than 2 conditions that need to be managed in a calendar month. Complex CCM requires moderate or high complexity in medical decision making.
The first code is 99487 for 60 minutes of complex CCM services. It pays a national average of $144 per patient per month.
There is an add-on code, 99489, for 30 additional minutes of complex CCM services. Its national average reimbursement rate it $78. You can bill this code an unlimited amount of time, so at 90 minutes, 120 minutes, and 150 plus minutes.
Physician-Driven CCM Codes
The first code is 99491 for 30 minutes of physician non-face-to-face CCM time. It has a national average reimbursement rate of $89.
And the add-on code, 99437, for an additional 30 minutes of physician time. It has a national average reimbursement rate of $63. You can bill this code an unlimited amount of time, so at 60 minutes, 90 minutes, and 120 plus minutes.
Again, with the reimbursement increases this year, there’s a great opportunity to grow your program and offer this valuable service to more patients. If you need help in starting or growing your CCM program, reach out to ThoroughCare.
Download a free reference guide for the CCM billing codes we discussed in the video.