Chronic Care Management
Bill the month of work that happens between visits.
Twenty minutes of care management a month, for patients with two or more chronic conditions.
Your team reviews. Your provider signs.
Eligibility
Who qualifies for CCM.
Twenty minutes of care management a month, for patients with two or more chronic conditions.
Chronic Care Management99490 · 99439 · 99487 · 99489 · 99491 · 99437
The patient
Two or more chronic conditions expected to last a year or longer.
If that does not describe your patient, nothing below applies.
The month
Twenty minutes of clinical staff time a month, away from the patient, against a care plan they have consented to.
Read it one patient at a time, exactly as it is written above.
Consent
Consent is inside the requirement above. The month runs against a care plan the patient has consented to.
How consent is taken and recorded, and whether a visit has to come first, are not settled on this page. We will not print a rule we cannot source. Ask us before you enroll anyone.
Not sure whether your patients count? Talk to us and we will go through your panel with you.
Programs are what your practice bills. HANA does not bill, and its call time is never counted as clinical time. Requirements here are the Medicare rules as they stand in October 2026 and are worth checking against your MAC before you rely on them.
What it pays
What CCM pays.
One base code, one patient, one month. National, before adjustment. Not what you collect.
$66.13
The first twenty minutes of clinical staff time in a calendar month, against a care plan the patient has consented to.
Medicare pays
$52.90
Patient owes
$13.23
Part B coinsurance. A known enrollment obstacle.
The code family
What else the same patient's month can carry. Same basis as the figure.
- 99490The base code on this page.$66.13
- 99487Complex CCM. Sixty minutes of clinical staff time, for a patient whose care plan needs moderate or high-complexity medical decision making.$144.29
- 99489Each further thirty minutes of complex CCM.An add-on to 99487, never billed alone.$78.16
- 99491Thirty minutes of the physician's or QHP's OWN time, not clinical staff time.Personal time only. Staff time does not count toward it, and it is not billed in the same month as 99490 for the same patient.$89.18
- 99437Each further thirty minutes of physician or QHP time.An add-on to 99491, and personal time only.$63.13
CCM · Who does what
HANA does the volume. Your team does the deciding.
HANA does the reaching out and the writing up. Every clinical judgement stays with your people, and nothing bills until a person on your team approves it.
HANA does
The work that repeats
- Calls every patient on the panel at the cadence the protocol asks for, not the cadence the roster allows.
- Captures adherence, symptoms and the barrier behind them in the patient's own words.
- Writes the call back into the time log as a structured summary, so nobody types it.
- Flags the answers that cross a threshold your clinician set.
Your team does
Never delegated
Reviews the summary, adds their own work, attests. The minutes on the claim are your team's minutes.
Your team reviews, your provider signs.
What the month leaves in the record
- Structured call summary
- Care-plan touch
- Flag queue
The record is built while the work happens, not afterwards.
How it works
Forty-five minutes a patient.
We take it under thirty.
One coordinator. Same hours. Two hundred and fifty patients instead of a hundred and fifty.
Hana calls · you set the protocol
It calls from your number until someone picks up. Then medications, symptoms, and what changed.
Hana routes · your team decides
Anything clinical goes to your team, with the reason and the transcript attached.
Your clinician reviews · Hana writes
The note is in the chart before your team opens it. Under that patient, not in a spreadsheet.
You submit · Hana supplies the evidence
Every minute attributed to the person who earned it, ready to attest on the first.
You set the escalation rules. A person on every clinical flag, an audit trail on every call, minutes totalled per patient.
45-60min
per patient, per month, today
What a coordinator spends on one enrolled patient when the calling, the chasing and the note are all done by hand.
120-160
the caseload that caps at
Which is why most programs stall well short of what the panel could support.
29min
what HANA is built for
Same coordinator, same hours, toward 250 patients. HANA makes the calls; your team reviews and attests.
Your team reviews it. Your provider signs it. Nothing is billed until a person on your team approves it.
The month is written up before you start your time.
Every contact HANA makes is recorded and summarised straight into the patient's record. When your clinician opens the patient, the month is already there, and the time they log is their own: reviewing, acting on what HANA flagged, and attesting. Not typing.
0:00
Time your team spends writing the month up
4
Documented contacts waiting when they open the chart
Time log · an example month
CCM 99490Taking both blood pressure meds. Home reading 138/86.
HANA call · summarised
Metformin refill due Friday. Two skipped breakfasts this week.
HANA call · summarised
158/94 on two home readings. Escalated to Dr Reyes with the full call.
HANA call · flagged to the threshold you set
Dose adjusted 20 Aug. Back to 134/84. Goals reconfirmed with the patient.
HANA call · summarised
Your clinician's time
Review and attest
3:00
Program math
The rate is set. The enrollment is not.
Medicare sets the rate. You set how much of your eligible panel is on the program, and that is where the whole figure comes from.
One program, one month
What a month of this program comes to
Set the panel and the enrollment. The rate is the multiplier and it sits still.
$661
estimated, per month
10 of 250 eligible patients enrolled on CCM. 99490, CY2026 rate.
Eligibility is yours to count. CCM asks for this: Two or more chronic conditions expected to last a year or longer. The marks are starting points, not claims about your panel.
How the figure is built
10 enrolled patients on CCM 99490, at $66.13 each, comes to $661 a month.
$66.13
per enrolled patient, per month · Chronic Care Management · 99490 · 99439
The arithmetic
250 eligible patients4% enrolled10 on the program
10 on the program$66.13 per patient, per month$661 a month
What the code pays for. The first twenty minutes of clinical staff time in a calendar month, against a care plan the patient has consented to.
99490, national non-facility, Medicare PFS CY2026.
The 4% default: in 2019, that share of eligible Medicare fee-for-service patients was actually enrolled. Enrollment has grown since, so read it as a floor. Source: Colligan E et al., “Analysis of 2019 Medicare Fee-for-Service Claims for Chronic Care Management and Transitional Care Management Services”, NORC at the University of Chicago for HHS ASPE, March 2022..
An estimate, not a quote and not billing advice. One base code per enrolled patient per month, before add-on codes, geography, sequestration and the patient's share, and it assumes every enrolled patient bills every month, which no real month does. Check it against your MAC.
Have a chat with HANA.
Give us your number. It calls in about ten seconds. Talk to it like a patient would, then let your team try it.
Hear Hana handle a real patient conversation.
Enter your details. Hana texts you to confirm, then calls within seconds, so you can hear it for yourself.
Questions practices ask
Before you start.
Two or more chronic conditions expected to last a year or longer. Against a care plan they have agreed to.
Twenty minutes of clinical staff time a month, away from the patient, against a care plan they have consented to.
Reviews the summary, adds their own work, attests. The minutes on the claim are your team's minutes. HANA makes the calls and writes them up.
99490 is $66.13, CY2026 national, before adjustment. Sequestration and the patient coinsurance both come off, so it is not what you collect.
No. Your patients, your claim. HANA supplies the reach and the documentation. Your team supplies the judgement.
Verbally or in writing, once, before CCM starts, and documented in the patient's record. The patient has to be told that the service is available, that cost sharing applies, that only one practitioner can bill CCM in a month, and that they can stop at any time. A new consent is only needed if they move to a different billing practitioner.
Only new patients, or patients the billing practitioner has not seen in the past year. For them, CCM starts at a face-to-face visit where it is discussed: a level 2 to 5 office visit, an annual wellness visit, an initial preventive physical exam, or the visit inside transitional care management. The billing practitioner does that visit, and it is billed on its own.
Physicians, nurse practitioners, physician assistants, clinical nurse specialists and certified nurse midwives. The clinical staff time on 99490 runs under general supervision, so the practitioner does not have to be in the room. CMS counts only time spent by clinical staff toward the twenty minutes, which is why HANA's call time never counts. The time your staff spend reviewing and acting on what HANA hands them does.
Behavioral health integration, yes, in the same month, with consent for both. Principal care management, not by the same practitioner: a specialist can bill PCM for a different condition while your practice bills CCM. Advanced primary care management, not by the practitioner billing APCM that month. In every case a minute counts toward one code only.
As proposed in July 2026, nothing for CCM. The proposal that would require staff employed by the practice covers remote physiologic and therapeutic monitoring only. CMS also asked for comments on supervision across care management, so the final rule, expected around November 2026, could still move. This page will say so when it does.
Yes. G0511 stopped being billable on 30 September 2025, and FQHCs and RHCs now bill the same CCM codes as everyone else, paid at the national non-facility rate on top of the visit payment.
Ready when you are
Hear it make the call. Then decide.
Bring your panel numbers. We will go through which programmes your patients already qualify for, and what your team would still do.
- Your patients, your claim
- Your team reviews and attests
- Nothing bills until a person approves