CMS October 2026Physician Fee Schedule · Free lookup

CPT 99490 Medicare Fee Schedule 2026

Medicare's 2026 national payment for CPT 99490 is $66.13 in a non-facility setting ($43.76 in a facility), up 9.3% from $60.49 in 2025.

National rate, October 2026

Non-facility: $66.13
Facility: $43.76
vs. 2025: +9.3%
Commercial national avg.: $67.13

Filters

HCPCS Codes

99490

State

Year

20262025

Select one or more years

Up to 5 codes · 4 remaining

Need commercial rates?

Compare Medicare against in-network rates from 180+ payers.

Run a free sample report

Showing

Physician Fee Schedule·99490·National·2026, 2025

Current non-facility rate

$66.13▲0.0%

Facility: $43.76

Recent trend

Code description

Chrnc Care Mgmt Staff 1st 20, 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 First 20 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
99490	10/2026	N/A	$66.13	$43.76	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99490	7/2026	N/A	$66.13	$43.76	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99490	4/2026	N/A	$66.13	$43.76	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99490	1/2026	N/A	$66.13	$43.76	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99490	10/2025	N/A	$60.49	$47.87	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99490	7/2025	N/A	$60.49	$47.87	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99490	4/2025	N/A	$60.49	$47.87	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month
99490	1/2025	N/A	$60.49	$47.87	Chrnc Care Mgmt Staff 1st 20, 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 First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month

99490 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	$66.13	$43.76	+9.3%
October 2025	$60.49	$47.87	-3.3%
March 2024	$62.58	$49.60	-0.2%
January 2023	$62.69	$50.49	-2.1%
July 2022	$64.02	$51.56	-

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.

99490: Medicare vs. commercial national average

The commercial national average for 99490, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $67.13, 101% of Medicare's $66.13.

BCBS $67.30
UnitedHealthcare $54.18
Aetna $59.36
Cigna $87.67

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 99490 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 99490

Nearby codes

99458 Medicare rate 99459 Medicare rate 99487 Medicare rate 99495 Medicare rate 99496 Medicare rate 99497 Medicare rate

PayerPrice Platform

Compare Medicare's rate for 99490 with published commercial rates

Search negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code. Review historical rates or export the data through API, SQL, MCP, or bulk download.

Schedule a demo Run a free sample report

Medicaid comparison

See what state Medicaid programs pay for 99490

50 state Medicaid agencies publish their own physician fee schedule. The 99490 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 99490

$144.29

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

99491Chrnc Care Mgmt Svc 30 Min, Chronic Care Management Services Provided Personally By A Physician Or Other Qualified Health Care Professional At Least 30 Minutes Of Physician Or Other Qualified Health Care Professional Time Per Calendar Month 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 Place The Patient At Significant Risk Of Death Acute Exacerbation/Decompensation Or Functional Decline; Comprehensive Care Plan Established Implemented Revised Or Monitored.

$89.18

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