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    v1.0.30
    OpenPayerBilling CodesTelephone ServicesCPT cpt-99437-chronic-care-management-additional-30-minutes
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    CPT 99437: Chronic Care Management Additional 30 Minutes

    Medicare pays $65 on average nationally for this procedure.

    CPT code 99437 describes an add-on chronic care management service in which a physician or other qualified healthcare professional personally performs management and care plan services for a patient with two or more chronic conditions expected to last at least one year or until the patient’s death; this code is reported for each additional 30 minutes of clinician time per calendar month beyond the first 30 minutes and represents chronic care management provided typically in outpatient or ambulatory settings as part of ongoing care coordination and complex care management.

    For related coverage guidance, see recent payer policy updates: Diabetic Supplies, Radiofrequency Ablation for Thyroid Nodules, Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 78-year-old patient with multiple chronic conditions — congestive heart failure, type 2 diabetes mellitus with neuropathy, and chronic obstructive pulmonary disease — presents for monthly complex chronic care management. The treating physician (or other qualified healthcare professional) performs a comprehensive care plan review and active management that requires more than the initial 30 minutes of direct practitioner time in the calendar month. The workflow includes review of recent hospital discharge summaries and medication lists, remote monitoring data review (weight, blood glucose, pulse oximetry), coordination with the home health nurse and cardiology, adjustment of medications, documentation of a revised problem list and goals, and synchronous or asynchronous communication with the patient and caregivers. The clinician documents cumulative time spent personally managing the patient for the month, and after the first 30 minutes bills 99437 for each additional 30-minute increment when the clinical complexity and coordination exceed the base time allowance.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99490Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional per calendar month, with chronic conditionsOften billed for lower-intensity monthly chronic care management when staff time (not physician time) meets the minimum; 99437 applies to additional physician/qualified professional time beyond initial 30 minutes.

    | 99439 | Chronic care management services, each additional 20 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 service) | Used for additional staff time increments; pairs with primary CCM codes when extra staff resources are required alongside physician management.

    | 99487 | Complex chronic care management services, first hour of clinical staff time directed by a physician or other qualified health care professional per calendar month; moderate or high complexity medical decision making | Represents the intensive care management service for complex patients; may be used in care plans where higher complexity is met and physician time complements staff-directed services.

    | 99489 | 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 service) | Used for additional staff time in complex CCM; complements physician time billed with 99437 when both staff and physician time exceed base units.

    | 99495 | Transitional care management services with moderate complexity (interactive contact within 2 business days and face-to-face within 14 days) | Frequently performed after hospital discharge in the care continuum; documentation of transitional care activities may overlap with monthly care plan management and coordination.

    | 99496 | Transitional care management services with high complexity (interactive contact within 2 business days and face-to-face within 7 days) | Used for higher complexity post-discharge management; relevant when intensive post-acute coordination is part of the monthly management time.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    207R00000X
    208000000X
    363A00000X
    1744G0900X
    163WP0218X
    1835P1300X
    111NN1001X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    B20Human immunodeficiency virus [HIV] disease
    C50.912Malignant neoplasm of unspecified site of left female breast
    E03.9Hypothyroidism, unspecified
    E11.65Type 2 diabetes mellitus with hyperglycemia
    E11.9Type 2 diabetes mellitus without complications
    E66.9Obesity, unspecified
    E78.5Hyperlipidemia, unspecified
    F17.200Nicotine dependence, unspecified, uncomplicated
    F32.9Major depressive disorder, single episode, unspecified
    G30.9Alzheimer's disease, unspecified

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    10 rows

    PolicyPayerEffective Date
    Diabetic SuppliesCigna2026-10-15
    Radiofrequency Ablation for Thyroid NodulesCigna2026-10-15
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only)UnitedHealthcare2026-10-01
    Tzield (teplizumab-mzwv) CoverageUnitedHealthcare2026-10-01
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Indiana Only)UnitedHealthcare2026-10-01
    Medical Necessity Guidelines Insulin PumpsMass General Brigham Health Plan2026-10-01
    Medical Necessity Guidelines: Continuous Glucose MonitorsMass General Brigham Health Plan2026-10-01
    Continuous Glucose MonitoringAmbetter Nevada2026-10-01
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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