CMS October 2026Physician Fee Schedule · Free lookup

CPT 99487 Medicare Fee Schedule 2026

Medicare's 2026 national payment for CPT 99487 is $144.29 in a non-facility setting ($79.16 in a facility), up 9.6% from $131.65 in 2025.

National rate, October 2026

Non-facility: $144.29
Facility: $79.16
vs. 2025: +9.6%
Commercial national avg.: $138.48

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HCPCS Codes

99487

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Year

20262025

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Up to 5 codes · 4 remaining

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Physician Fee Schedule·99487·National·2026, 2025

Current non-facility rate

$144.29▲0.0%

Facility: $79.16

Recent trend

Code description

Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month

Code	Date	State	Non-Facility Fee	Facility Fee	Description
99487	10/2026	N/A	$144.29	$79.16	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99487	7/2026	N/A	$144.29	$79.16	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99487	4/2026	N/A	$144.29	$79.16	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99487	1/2026	N/A	$144.29	$79.16	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99487	10/2025	N/A	$131.65	$87.01	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99487	7/2025	N/A	$131.65	$87.01	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99487	4/2025	N/A	$131.65	$87.01	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99487	1/2025	N/A	$131.65	$87.01	Cplx Chrnc Care 1st 60 Min, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making First 60 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month

99487 national rate by year

Each row is the latest CMS file published that year. Change is against the year before.

CMS file	Non-facility	Facility	Change
October 2026	$144.29	$79.16	+9.6%
October 2025	$131.65	$87.01	-1.9%
March 2024	$134.15	$89.21	+0.7%
January 2023	$133.18	$90.82	-0.8%
July 2022	$134.27	$92.75	-

This is the national amount before geographic adjustment. Medicare multiplies each relative value unit by its locality's geographic practice cost index, so a practice's own allowed amount can be higher or lower; pick a state above to see its localities. The facility amount applies when the service is performed in a hospital or other facility setting.

99487: Medicare vs. commercial national average

The commercial national average for 99487, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $138.48, 96% of Medicare's $144.29.

BCBS $134.84
UnitedHealthcare $110.81
Aetna $121.88
Cigna $186.37

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 99487 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its national non-facility amount before geographic adjustment.

See commercial rates in your market Commercial rates for 99487

Nearby codes

99457 Medicare rate 99458 Medicare rate 99459 Medicare rate 99490 Medicare rate 99495 Medicare rate 99496 Medicare rate

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Medicaid comparison

See what state Medicaid programs pay for 99487

50 state Medicaid agencies publish their own physician fee schedule. The 99487 page shows real published rates for several of them free, with effective dates and official sources.

17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.

See Medicaid rates for 99487

$57.45

99489Cplx Chrnc Care Ea Addl 30, Complex Chronic Care Management Services With The Following Required Elements Multiple Two Or More Chronic Conditions Expected To Last At Least 12 Months Or Until The Death Of The Patient Chronic Conditions That Place The Patient At Significant Risk Of Death Acute Exacerbation Decompensation Or Functional Decline Comprehensive Care Plan Established Implemented Revised Or Monitored Moderate Or High Complexity Medical Decision Making Each Additional 30 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month List Separately In Addition To Code For Primary Procedure

$78.16

99483Assmt Care Pln Pt Cog Imp, Assessment Of And Care Planning For A Patient With Cognitive Impairment Requiring An Independent Historian In The Office Or Other Outpatient Home Or Domiciliary Or Rest Home With All Of The Following Required Elements Cognition Focused Evaluation Including A Pertinent History And Examination Medical Decision Making Of Moderate Or High Complexity Functional Assessment Eg Basic And Instrumental Activities Of Daily Living Including Decision Making Capacity Use Of Standardized Instruments For Staging Of Dementia Eg Functional Assessment Staging Test Fast Clinical Dementia Rating Cdr Medication Reconciliation And Review For High Risk Medications Evaluation For Neuropsychiatric And Behavioral Symptoms Including Depression Including Use Of Standardized Screening Instrument S Evaluation Of Safety Eg Home Including Motor Vehicle Operation Identification Of Caregiver S Caregiver Knowledge Caregiver Needs Social Supports And The Willingness Of Caregiver To Take On Caregiving Tasks Development Updating Or Revision Or Review Of An Advance Care Plan Creation Of A Written Care Plan Including Initial Plans To Address Any Neuropsychiatric Symptoms Neuro Cognitive Symptoms Functional Limitations And Referral To Community Resources As Needed Eg Rehabilitation Services Adult Day Programs Support Groups Shared With The Patient And Or Caregiver With Initial Education And Support Typically 60 Minutes Of Total Time Is Spent On The Date Of The Encounter

$292.93

Methodology

Rates are sourced directly from CMS Physician Fee Schedule files, indexed quarterly. Non-facility and facility prices are calculated using the published GPCI for each locality and the year's conversion factor.

View CMS Physician Fee Schedule