{
    "code": "99487",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99487/2023/A",
    "release_specific_url": "https://localishealth.com/cpt/99487/2023/C",
    "description": "A month of behind-the-scenes care coordination for a patient with multiple serious ongoing conditions, covering the first hour of clinical staff time under a clinician's direction. The staff maintain a comprehensive care plan and spend the month chasing the things that fall between appointments - coordinating with specialists, reconciling medications, arranging home services, following up after hospital stays, and taking patient and caregiver calls. What separates it from ordinary chronic care management is both the amount of time and the difficulty of the decisions involved, which have to rise above routine.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99487 in Q3 2023?",
        "text": "Medicare paid $133.18 for CPT 99487 in the office (non-facility) setting and $90.82 in a facility under the Q3 2023 Physician Fee Schedule, effective July 2023. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2023, when it decreased 0.8%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2023,
        "quarter": "C",
        "label": "Q3 2023",
        "effective": "July 1 – September 30, 2023",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 133.18,
        "facility": 90.82,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.81,
        "practice_expense_non_facility": 2,
        "practice_expense_facility": 0.75,
        "malpractice": 0.12
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 33.8872,
    "source": {
        "label": "Physician relative value file (Q3 2023)",
        "cms_url": "https://www.cms.gov/files/zip/rvu23c.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2023/C",
        "file": "PPRRVU23_JUL.csv",
        "row": 18113,
        "sha256": "64251eae48773025b05c6e45a77e1909e7151c421fe8f346124ba9623c491e37"
    },
    "modified_at": "2026-08-04T03:12:57+00:00"
}