How Much Does Chronic Care Management Staff Initial 20 Cost?
Also known as: Chrnc care mgmt staff 1st 20 (CPT 99490)
Monthly chronic care management by clinical staff for patients with two or more chronic conditions, involving at least 20 minutes.
Chronic Care Management Staff Initial 20 (CPT 99490) costs $44 at Medicare rates.
The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.
Patient Guide: Chronic Care Management Staff Initial 20
What you need to know before your appointment
What to Expect
A care coordinator or nurse will manage your multiple chronic conditions by coordinating care, monitoring your health, and helping you follow your treatment plan.
How Long Does It Take?
20 minutes per month
Common Reasons Doctors Order This
Managing multiple chronic conditions like diabetes with high blood pressure, heart disease with kidney disease
How to Prepare
Keep a health diary. Take your medications as prescribed and note any side effects to report.
Procedures Commonly Done Together
These procedures are frequently performed alongside Chrnc care mgmt staff 1st 20
How to Reduce Your Cost for Chrnc care mgmt staff 1st 20
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
For this procedure, the office rate ($66) differs from the facility rate ($44). Ask if it can be done in an office setting.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (1.98) x CF ($33.40) = $66
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Chrnc care mgmt staff 1st 20 cost?
The Medicare facility rate for Chrnc care mgmt staff 1st 20 is $44. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Chrnc care mgmt staff 1st 20 cost without insurance?
Without insurance, the cost of Chrnc care mgmt staff 1st 20 can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Chrnc care mgmt staff 1st 20?
Most commercial health insurance plans and Medicare cover Chrnc care mgmt staff 1st 20 when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.