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99439

Chronic care management services, each additional 20 minutes (add-on)

Evaluation and Management Care Management Services N/A (time-based care management add-on) Complexity 1.15 Total RVUs
Quick Reference
Additional 20 minutes of chronic care management beyond initial 99490 time requirement

Audit Defense & Denial Intelligence

Research-based denial patterns from OrbDoc Bill Analyzer

High overall risk
Top issues: Additional CCM time not documented or cumulative monthly time below threshold

1. Additional CCM time not documented or cumulative monthly time below threshold

Very Common

99439 (additional 20 minutes chronic care management) can ONLY be billed when 99490 or 99491 already billed same month AND additional 20+ minutes documented beyond base code time. 99490 requires 20 min/month. Billing 99490 + 99439 requires 40+ minutes cumulative monthly time documented with care plan activities. Cannot bill 99439 without base CCM code same month.

Common Causes

  • Billed 99439 without 99490 or 99491 same month - denied as standalone code
  • Total monthly CCM time 35 minutes - only covers 99490, not enough for 99439 add-on
  • Time documented weekly but not aggregated to show monthly total

Resolution Strategy

Document cumulative monthly CCM time log: 'June 2025 CCM time: June 5 (12 min - medication reconciliation), June 12 (15 min - reviewed cardiology consult with patient), June 19 (8 min - care plan update), June 26 (10 min - scheduled specialist). Total: 45 minutes.' Must show 20+ min base (99490) + 20+ min additional = 40+ min total for 99439. Ensure base CCM code billed same month before 99439. Appeal with time log showing 40+ min cumulative monthly time.

Appeal Success: Medium
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Relative Value Units (RVUs)

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Work RVU
0.70
Physician effort
PE RVU
0.41
Practice expense
MP RVU
0.04
Malpractice
Total RVU
1.15
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

Additional 20 minutes of chronic care management beyond initial 99490 time requirement

Time Requirement
Each additional 20 minutes of CCM services beyond initial 20 minutes in 99490

Common Scenarios

Complex medication management requiring extended pharmacist/nurse time
Extensive care coordination with multiple specialists
Behavioral health integration requiring additional counseling time
Complex social needs requiring extended case management
Frequent monitoring and adjustment of treatment plans

Documentation Requirements

  • Specific time spent on CCM activities documented
  • Activities performed during additional time described
  • Patient contact or care coordination details
  • Updates to comprehensive care plan

Coding Guidelines

Common Modifiers

None typically required Add-on code used with 99490

Bundling Rules

  • Must be billed with 99490 (initial 20 min CCM)
  • Cannot be billed alone; requires base CCM code
  • Can bill multiple units for extended time
  • Each unit = 20 additional minutes

Exclusions

  • 99487-99489 (complex CCM; use instead for 60+ min total time)
  • Cannot be billed same month as complex CCM codes
  • 99491 (principal care management; different service)

Coding Notes

Example: 50 min total CCM = 99490 (first 20) + 99439 x1 (next 20) + partial credit
If total time exceeds 60 min, consider 99487 instead (complex CCM pays better)
Must have comprehensive care plan in place
Patient consent required for CCM services

Clinical scenarios

Complex medication management requiring extended pharmacist/nurse time
Complex medication management requiring extended pharmacist/nurse time
When to use:Additional 20 minutes of chronic care management beyond initial 99490 time requirement
  • Specific time spent on CCM activities documented
  • Activities performed during additional time described
  • Patient contact or care coordination details
Pitfalls:Additional CCM time not documented or cumulative monthly time below threshold
Extensive care coordination with multiple specialists
Extensive care coordination with multiple specialists
When to use:Additional 20 minutes of chronic care management beyond initial 99490 time requirement
  • Specific time spent on CCM activities documented
  • Activities performed during additional time described
  • Patient contact or care coordination details
Pitfalls:Additional CCM time not documented or cumulative monthly time below threshold
Behavioral health integration requiring additional counseling time
Behavioral health integration requiring additional counseling time
When to use:Additional 20 minutes of chronic care management beyond initial 99490 time requirement
  • Specific time spent on CCM activities documented
  • Activities performed during additional time described
  • Patient contact or care coordination details
Pitfalls:Additional CCM time not documented or cumulative monthly time below threshold

Who are you?

Code Details

Code 99439
Category Evaluation and Management
Subcategory Care Management Services
Total RVUs 1.15

Medicare Pricing

PFS
2025 National Rate
$45.93
Facility
$32.99
Non-Facility
$45.93
RVU Breakdown
Work RVU:0.70PE RVU:0.68MP RVU:0.04Total RVU:1.42CF:$32.3465Global Days:ZZZ
OPPS Details
Status:NCopayment:$0.00
Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 99439?

CPT 99439 is the billing code for "Chronic care management services, each additional 20 minutes (add-on)". Additional 20 minutes of chronic care management beyond initial 99490 time requirement

How much does Medicare pay for CPT 99439?

Medicare pays approximately $45.93 for CPT 99439 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

What are the RVUs for CPT 99439?

CPT 99439 has a total RVU of 1.15, broken down as: Work RVU 0.70, Practice Expense RVU 0.41, and Malpractice RVU 0.04. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Why was my 99439 claim denied?

The most common denial reason for CPT 99439 is "Additional CCM time not documented or cumulative monthly time below threshold". 99439 (additional 20 minutes chronic care management) can ONLY be billed when 99490 or 99491 already billed same month AND additional 20+ minutes documented beyond base code time. 99490 requires 20 min/month. Billing 99490 + 99439 requires 40+ minutes cumulative monthly time documented with care plan activities. Cannot bill 99439 without base CCM code same month. Common causes include: Billed 99439 without 99490 or 99491 same month - denied as standalone code; Total monthly CCM time 35 minutes - only covers 99490, not enough for 99439 add-on. Appeal success rate is approximately 40-60%.

What documentation is required for CPT 99439?

Key documentation requirements for CPT 99439 include: Specific time spent on CCM activities documented; Activities performed during additional time described; Patient contact or care coordination details; Updates to comprehensive care plan. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 99439 be billed with other codes?

Bundling considerations for CPT 99439: Must be billed with 99490 (initial 20 min CCM). Cannot be billed alone; requires base CCM code Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 99439?

Common modifiers for CPT 99439 include: None typically required (Add-on code used with 99490). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

What is the time requirement for CPT 99439?

The typical time requirement for CPT 99439 is Each additional 20 minutes of CCM services beyond initial 20 minutes in 99490. Time-based codes require documentation of the actual time spent providing the service.

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