CPT 99487: Complex Chronic Care Management, First 60 Minutes
CPT 99487 reports the first 60 minutes of clinical staff time in complex chronic care management (CCM) per calendar month, involving moderate- to high-complexity decision making and substantial care-plan revision. In 2026 Medicare pays about $144.29 non-facility (4.32 total RVUs times the $33.4009 conversion factor).
- Code type
- Complex CCM (staff, first 60 min)
- 2026 non-facility
- $144.29 (4.32 RVUs)
- 2026 facility
- $79.16 (2.37 RVUs)
- Requirement
- 60 min staff time + moderate/high MDM
What is CPT 99487 used for?
CPT 99487 is the base complex chronic care management code, reporting the first 60 minutes of clinical staff time per calendar month for a patient whose care requires moderate- to high-complexity medical decision making and substantial care-plan establishment or revision. It is CCM for the most involved patients, multiple unstable conditions, frequent adjustments, heavy coordination.
Complex CCM shares the general CCM eligibility rules, two or more chronic conditions expected to last at least 12 months, patient consent, a comprehensive electronic care plan, and 24/7 access, but it adds two requirements that non-complex CCM does not: the month's decision making must reach moderate or high complexity, and the care plan must be established or substantially revised. Those two elements, not the clock, are what separate 99487 from 99490.
How much does 99487 pay in 2026?
99487 carries 4.32 non-facility RVUs and 2.37 facility RVUs. At the 2026 conversion factor of $33.4009 that is about $144.29 non-facility and $79.16 in a facility per month. It pays substantially more than non-complex CCM, reflecting the higher decision-making burden, and when the work runs past 60 minutes each additional full 30 minutes stacks on with 99489. Model it on the Medicare fee calculator.
Complex or non-complex CCM?
The decision turns on decision-making complexity and care-plan work, not just minutes. For a given patient in a given month you bill either complex CCM (99487 plus 99489) or non-complex CCM (99490 plus 99439), never both:
| Code | Service | 2026 non-facility |
|---|---|---|
| 99487 | Complex CCM, first 60 min | ~$144.29 |
| 99489 | Complex CCM, each addl 30 min | ~$78.16 |
| 99490 | Non-complex CCM, first 20 min | ~$66.13 |
Example: a patient with decompensated heart failure and poorly controlled diabetes whose staff coordinate specialist visits, reconcile new medications, and substantially revise the care plan over 65 documented minutes supports 99487 at about $144.29 for the month, well above the ~$66.13 that non-complex CCM would pay.
Frequently asked questions
Complex CCM requires moderate- to high-complexity medical decision making and the establishment or substantial revision of a comprehensive care plan, plus at least 60 minutes of clinical staff time in the month. It is not just more time; the clinical complexity and care-plan work must be documented, which distinguishes it from non-complex CCM (99490).
The 2026 national non-facility allowed amount is about $144.29 (4.32 total RVUs times $33.4009) and about $79.16 in a facility. It pays substantially more than non-complex CCM, reflecting the higher decision-making burden.
No. For a given patient in a given month you bill either complex CCM (99487, plus 99489 add-ons) or non-complex CCM (99490, plus 99439), not both. Choose the family that matches the documented complexity and care-plan work, and do not double-count minutes.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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