CPT-99437

Add a code for non-complex CCM service for each extra 30 minutes by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure).

CATEGORY

Chronic Care Management Services

CODE TYPE

Timed-based code
Billed in 30 minutes increment

ADD-ON CODE

CPT 99437 is an add-on code for 99491 and is billed to patients receiving chronic care management services, for each additional 30 minutes of clinical staff time provided personally by a physician or other qualified health care professional. It can be billed once a month.

CODING CRITERIA

For CPT 99437, the following criteria should be met:
  • Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
  • For each additional 30 minutes of clinical staff time provided personally by a physician or other qualified health care professional
  • Chronic conditions that lead to the risk of death, acute exacerbation/decompensation, or functional decline of patient
  • Comprehensive care plan established, implemented, revised, or monitored
  • Billed once a month.

BILLING CRITERIA

Providers cannot bill more than one CCM claim for a patient per calendar month i.e. 30 days
CODE FIRST:
CPT code 99437 requires code first condition i.e. 99491

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CPT-99437

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