Understanding the Chronic Care Management Reimbursement Codes 99490 and G0511

This code is specific to Chronic Care Management and is the reimbursement of chronic care services for patients with:

Two or more chronic condition

To be reimbursed for such care, practices must:

Contact each eligible patient every month.
Conduct at least 20 minutes of non-face-to-face care.
Establish, implement, revise or monitor a comprehensive care plan.

Non-Face-To-Face Care Services provided by Care Waves

To help provide the best care to your patients, our nurses offer personalized care to each patient.

  • Initial Care Plan Review
  • Medication Review
  • Subsequent Care Plan Review
  • Symptoms Management
  • Preventive Health Review
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Chronic Care Management at a Glance

117 million Americans have one or more chronic health condition, 2/3 of Medicare beneficiaries have 2 or more chronic condition.
Patients with multiple chronic condition often visit multiple providers in different organizations, leading to duplication and conflicts in Care Plans.
Medicare began allowing physicians to bill for chronic care management (CCM) in 2015.
CMS specifies that the code must be billed for “non-face-to-face follow-up care outside the office” each month.

According to CMS, these chronic conditions include*:

  • Acquired Hypothyroidism
  • Acute Myocardial Infarction
  • Alzheimer’s Disease & Related Disorders
  • Anemia
  • Asthma
  • Atrial Fibrillation
  • Benign Prostatic Hyperplasia
  • Cancer. Colorectal
  • Cancer, Endometrial
  • Cancer. Breast
  • Cancer. Lung
  • Cancer. Prostate
  • Cataract
  • Chronic Kidney Disease
  • Chronic Obstructive Pulmonary Disease
  • Depression
  • Diabetes
  • Glaucoma
  • Heart Failure
  • Hip/Pelvic Fracture
  • Hyperlipidemia
  • Hypertension
  • lschemic Heart Disease
  • Osteoarthritis
  • Osteoporosis
  • Rheumatoid Arthritis
  • Stroke/Transient Ischemic Attack
” This is not an exclusive list of chronic conditions. CMS may recognize other conditions for purposes of providing CCM.