2024 Medicare CPT Code Reimbursements for Chronic Care Management (CCM)
This November, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule containing updates to the Physician Fee Schedule. This included a list of prices, reimbursement rates, and billing codes for various healthcare services, as well as costs related to chronic care management (CCM) and remote patient monitoring (RPM).
So, how did Medicare reimbursements from CMS for chronic care management change for 2024?
While traditional rates for most CCM CPT codes remained stable, CMS did increase the work RVU for the CCM BHI CPT code 99484 from 0.61 to 0.93 (50%+ increase) and also updated the billing rules for the RHC CCM HCPCS code (G0511) to allow for billing multiple units in a given calendar month.
Let’s break down all the changes to the CCM codes by CMS for 2024.
The 2024 Reimbursement Rates for the CMS CCM Codes
In 2024, the Relative Value Unit (RVU) Multiplier for all services and treatments billed to Medicare is $32.74. This is a 3.4% decrease from 2023. But it’s important to remember that RVU-based conversions also vary by both:
- Clinical specialty, and
- Geographic locations of facilities
That said, here’s a table of 2024 CPT codes for CCM treatments and average rates:
| 2024 CCM Reimbursement Rates | ||
|---|---|---|
| CPT Code | WHAT IT COVERS | 2024 rate |
| BASIC CCM | ||
| 99490 | The first 20 minutes of clinical chronic care management services for patients with two or more chronic conditions expected to last 12+ months. | $62* |
| 99439 | Each additional 20 minutes of clinical time directed by a healthcare professional for chronic care management services. | $47* |
| 99491 | At least 30 minutes of chronic care management services, delivered by the billing provider, for patients with two or more chronic conditions expected to last 12+ months. | $83* |
Changes to How Many Times G0511 Can Be Billed Per Month in 2024
It’s also important to note that November 2023’s Final Rule proposes changes to CCM HCPCS code G0511. Starting January 1, 2024:
- G0511 can be billed more than once per month.
- The weighted average payment for G0511 is $72.98.
- In order to bill multiple times, the requirements for G0511 must be satisfied multiple times; resource costs, however, should not be counted more than once.
Let’s break this down:
When billing for CCM services in Federally Qualified Health Centers (FQHC) or Rural Health Clinics (RHC), the HCPCS code G0511 is used. Starting on page 750 of November 2023’s Final Rule, CMS proposed changes for how many times this code could be billed. As of January 1, 2024, G0511 can be billed more than once per month so long as the requirements are met each time and resource costs are not counted multiple times.
2024’s average payment was based on the main and supplemental codes for CCM, PCM, RPM, and RTM. While all of these codes were used to determine the rate of G0511, they do not all need to be individually satisfied for providers to bill G0511 more than once a month.
See the table below for the updated reimbursement in 2024 under G0511:
| 2024 CCM Reimbursement Rates | ||
|---|---|---|
| CPT Code | Time Spent By Clinical Staff | 2024 Rate |
| RHC/FQHC CCM | ||
| G0511 | At least 20 minutes of qualified CCM or general BHI services furnished to a patient in a calendar month. | $72.98* |
Complex CCM Breakdown
Unlike basic CCM (code 99490), complex chronic care management (codes 99487 and 99489) requires higher level medical decision-making and more time.
Here, clinical staff can bill for reimbursement if they provide care to patients for at least 60 minutes. Also, both the patient and provider must agree that there has been an acute exacerbation of the patient’s chronic condition for the care to meet the complex CCM criteria.
Clinical staff providing complex CCM are also reimbursed for each additional 30 minutes spent in the same calendar month providing patient care for exacerbated chronic conditions. These services are billable under add-on code 99489.
| 2024 CCM Reimbursement Rates | ||
|---|---|---|
| CPT Code | Time Spent By Clinical Staff | 2024 Rate |
| Complex CCM | ||
| 99487 | The first 60 minutes of complex chronic care management services for patients with moderate to complex conditions. | $132* |
| 99489 | Each additional 20 minutes of complex chronic care management services for patients with moderate to complex conditions. | $71* |
Available Reimbursement Under BHI Care Management
As of January 1, 2024, CMS has refined the work RVU for code 99484, a code billed for General Behavioral Health Integration (BHI) Care Management. Since last year, the multiplier has increased from 0.61 to 0.93.
Below is the 2024 CPT code for BHI reimbursable under CCM:
| 2024 CCM Reimbursement Rates | ||
|---|---|---|
| CPT Code | Time Spent By Clinical Staff | 2024 Rates |
| BEHAVIORAL HEALTH INTEGRATION | ||
| 99484 | At least 20 minutes per calendar month. | $55* |
Maximize Your CCM and RPM Model with Signallamp
Both chronic care management and remote patient monitoring require efficient, supportive infrastructure for providers and patients alike—especially when it comes to correct billing. But in the face of high patient loads and changing regulations, providers need ample support to continue providing effective CCM and RPM services to patients.
At Signallamp, we provide the robust CCM and RPM support structure that providers need to sustain (and scale) their programs YOY. By streamlining enrollment and consent, assigning dedicated nurse care managers for monitoring and triage, and documenting directly in your EHR, Signallamp helps provider organizations take care further while also maximizing financial performance.
Ready to build a sustainable CCM program? Schedule a consultation with Signallamp today.
Sources:
Department of Health and Human Services. Medicare and Medicaid Programs. https://public-inspection.federalregister.gov/2023-24184.pdf
CMS. Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule . https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2024-medicare-physician-fee-schedule-final-rule
Proven Model. Trusted by Many.
