The CCM code family isn’t changing shape going into 2027, but the payment rates and the options around it are. You don’t need to bill these yourself, but you do decide which program each patient is in and who does the work, so you need the map. This page is the reference for CCM at the code level: what each code requires, what the newer APCM codes do to your choices, and what is changing for 2027.
The CCM Codes in Use Now
Code | Who does the work | What it covers | Approx. 2026 national average |
99490 | Clinical staff, directed by you | First 20 minutes per month | ~$62–66 |
99439 | Clinical staff | Each additional 20 minutes, up to two units | ~$47–50 |
99491 | You or another qualified practitioner, personally | First 30 minutes per month | ~$84–89 |
99437 | You or another qualified practitioner | Each additional 30 minutes, with 99491 | ~$63 |
99487 | Clinical staff, directed by you | First 60 minutes; moderate-to-high complexity decision-making; care plan established or substantially revised | ~$135–145 |
99489 | Clinical staff | Each additional 30 minutes, with 99487 | ~$70–78 |
Figures are approximate 2026 national averages, shown because 2027 rates aren’t final. They vary by locality and payer; confirm current rates through the CMS Physician Fee Schedule Look-Up Tool before relying on them for financial planning.
There are three paths in that table. Most independent practices run 99490 and 99439, because the coordination is delegated to staff under your direction. 99491 and 99437 exist for the less common case where you personally do the work. The complex tier is a clinical judgment, not a bigger version of the same code, and it gets its own treatment in Standard vs. Complex CCM.
A few rules sit across all three. Only one practitioner can bill CCM for a patient in a given month. A practitioner reports either the standard or the complex tier for a patient in a month, never both, and the practitioner-only codes can’t share a month with the staff-delivered ones. New patients, and established patients you haven’t seen in the past year generally need a qualifying visit before CCM begins.
The Newer Option: APCM
Advanced Primary Care Management isn’t a CCM code, but it’s now the alternative to one. Three HCPCS codes, G0556, G0557, and G0558, pay a flat monthly amount by tier, based on how many chronic conditions the patient has and whether they’re a Qualified Medicare Beneficiary. In 2026, they pay roughly $16, $54, and $117 per patient per month, and 2027 rates will move with the same conversion factor. There’s no minute tracking. Instead, a defined set of care elements has to be in place each month. New for 2026, three behavioral health add-on codes (G0568, G0569, G0570) attach to an APCM base code.
The catch is exclusivity. Billing APCM for a patient in a month generally rules out CCM, PCM, and TCM from the same practitioner for that patient that month. Billing guides report that a different practitioner, such as a specialist treating a separate condition, can still bill CCM in the same month when it’s medically necessary, so confirm that point with your compliance reviewer before relying on it. APCM can be billed alongside remote patient monitoring.
This makes the choice a per-patient, per-month decision: time-based CCM for the patient whose coordination is intensive, flat-rate APCM for the one whose needs are steadier. That decision is much easier to run when both programs are visible in the same place. Advaa Health builds its chronic care management software to run inside the EHR a practice already uses, which keeps each patient’s program for the month in the chart instead of a billing spreadsheet.
What Changes in 2027
Nothing below is final yet. CMS released its CY 2027 proposed rule on July 14, 2026, comments closed September 14, and the final rule is expected in early November, as in prior cycles.
The CMS fact sheet doesn’t propose changes to the CCM codes themselves, and industry summaries report CCM and APCM valuation as unchanged. The proposal does cut the conversion factor from $33.40 to a proposed $32.84 for most practitioners and from $33.57 to $33.17 for qualifying APM participants. That factor applies to every service on the fee schedule, so if it’s finalized as proposed, CCM payments would drift down by roughly 1 to 2 percent even with the codes untouched. The dollar ranges above are 2026 figures; until the final rule is published, plan against modestly lower numbers for 2027.
The larger long-term signal is a request for comment, not a proposal. CMS is seeking input on redesigning primary care payment, including prospective payment models and the role of technology. A law firm summary of the rule says CMS is also asking whether existing care management services, including CCM, PCM, TCM, and APCM, should be simplified or consolidated. That’s a question, but it’s the one worth watching.
Two adjacent proposals aren’t CCM codes but touch the same chronic care work: new advance care planning codes for clinical staff, and separate coding for shared medical appointments. The remote monitoring proposals in the same rule affect RPM rather than CCM; we cover them in what CMS proposed for RPM in 2027.
Common Reasons CCM Claims Get Denied
Most denials come from the rules above colliding: both tiers billed in one month, CCM and APCM billed by the same practitioner in the same month, or two practitioners billing CCM for the same patient. Time is the other common cause. The 20-minute floor for 99490 is firm, and a month that reaches 18 minutes isn’t billable. Beyond that, claims fail when the initiating visit, the care plan, or the consent isn’t in the record, or when the patient doesn’t actually have two qualifying chronic conditions- the question OIG has put on its Work Plan for CCM as of this writing.
Frequently Asked Questions
Can CCM and RPM be billed in the same month?
Yes, as long as the time and activities counted toward each are genuinely separate. Our RPM CPT Codes Explained hub covers the monitoring side, and combining RPM and CCM covers how the two fit together.
Can I bill 99490 and 99487 for the same patient in the same month?
No. It’s one tier or the other.
Can the same practitioner bill CCM and APCM for the same patient in the same month?
Generally no. It’s one program per patient per month for that practitioner.
The Bottom Line
The CCM codes themselves are stable going into 2027. The things that move are the payment rate, the APCM alternative, and a CMS question about whether this whole family should eventually be simplified. Build your workflow around the patient’s needs and the record, and let the code choice follow from them.
