CPT 99489 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

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 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)

Key Fact	Detail
Service Type	• Evaluation and Management • Care Management Services
Common Place of Service	• 11 - Office • None • 99 - Other POS
Common Modifiers	• None • 25 - Significant, separately identifiable E/M service same day • 95 - Telemedicine - audio and video
Complexity Level	Low

National average reimbursement for CPT 99489 by major payers:

$70.57

$56.55

$62.34

$104.24

Preview provider-level rates for...

For billing codeCPT 99489

Payer	Code	Rate	NPI	Tax ID	State	Specialty
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 99489
United	99489	$110.62	1881840007 - DAVID HOFFMAN	756002868	TX	Internal Medicine Physician (207R00000X)
United	99489	$109.33	1790096998 - JUNAID KALIA	390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS	TX	Neurology Physician (2084N0400X)
United	99489	$56.88	1669436200 - EVELIO GARCIA	203291440 - (TX) GARLAND CARDIAC IMAGING	TX	Cardiovascular Disease Physician (207RC0000X)
United	99489	$59.06	1316919020 - YUHOE DICE	752616977 - CHRISTUS TRINITY CLINIC	TX	Internal Medicine Physician (207R00000X)
United	99489	$71.62	1710460233 - NICOLE DILANDO	43567824 - (MA) CHILDREN'S HEALTH CARE, INC.	MA	Pediatrics Physician (208000000X)
United	99489	$73.83	1649614694 - PRADEEP PANUGANTI	742958277 - SCOTT & WHITE CLINIC	TX	Neurology Physician (2084N0400X)
United	99489	$61.61	1699979286 - ELENA SHANINA	760010407	TX	Neurology Physician (2084N0400X)
United	99489	$19.47	1811140627 - RITA JERMYN	113613997 - (NY) CHS PHYSICIAN PARTNERS PC	TX	Cardiovascular Disease Physician (207RC0000X)
United	99489	$40.27	1861505539 - RAMON PINEDA	760367510 - (TX) RAMON A PINEDA MD PA	TX	Internal Medicine Physician (207R00000X)
United	99489	$84.70	1841795002 - HEMALI PATEL	260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP	TX	Neurology Physician (2084N0400X)
United	99489	$131.77	1992122212 - NINA GOLD	42697983 - MASS GENERAL BRIGHAM INCORPORATED	MA	Pediatrics Physician (208000000X)
United	99489	$35.79	1477525384 - MAXIMILIANO HERNANDEZ	742898592 - (TX) MAXIMILIANO E. HERNANDEZ, M.D., P.A.	TX	Internal Medicine Physician (207R00000X)
United	99489	$43.56	1295739126 - ANDREW DENTINO	204701276	TX	Internal Medicine Physician (207R00000X)
United	99489	$30.98	1285761809 - ZARATE MEDICAL GROUP PA	204025746 - (TX) ZARATE MEDICAL GROUP PA	TX	Internal Medicine Physician (207R00000X)
United	99489	$41.20	1194795310 - LITTLE ELM MEDICAL CLINIC PA	752867549 - (TX) LITTLE ELM MEDICAL CLINIC PA	TX	Internal Medicine Physician (207R00000X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 99489 vs. Other Care Management Services Codes

The CPT 99489 code is part of the Evaluation and Management services used for Care Management Services. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 99489 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
99484-CPT	Low	Care Management Services For Behavioral Health Conditions At Least 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qualified Health Care Professional Per Calendar Month Withthe Following Required Elements: Initial Assessment Or Follow-Up Monitoring Including The Use Of Applicable Validated Rating Scales; Behavioral Health Care Planning In Relation To Behavioral/Psychiatric Health Problems Including Revision For Patients Who Are (Desc Rvsd 1/1/22)
99487-CPT	Low	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 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.
99489-CPT	Low	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 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)
99490-CPT	Low	Chronic Care Management Services With The Following Required Elements: Multiple (Two Or More)Chronicconditions Expected To Last At Least 12 Months Oruntil The Death Of The Patient Chronic Conditionsplace The Patient At Significant Risk Of Death Acute Exacerbation/Decompensation Or Functional Decline Comp Care Plan Established Implemented Revised Or Monitored; First 20 Minutes Of Clinical Staff Time Directed By A Physician Or Other Qhp Per Calendar Month. (Desc Rvsd 1/1/22)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99489. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 99489 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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