An add-on code for Complex chronic care management services for patients having multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient. These Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. The services include establishment or substantial revision of a comprehensive care plan, each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month. The code 99489 is listed separately in addition to code for primary procedure.