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CPT 99489 Medicare payment status

Additional Complex Chronic Care Management

Bundled / not separately paid

99489 · PFS Q1 2013 · Historical

No national PFS rate in Q1 2013

Status B is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CMS RVU13AJanuary 1 – March 31, 2013revision 2

PFS status evidence

Physician relative value file (Q1 2013) · rvu13ar.zip (PPRRVU13_V1226_UP0.csv row 15,608)
Inspect PFS status evidence
Code
99489
Release
Q1 2013, revision 2
Result
Bundled / not separately paid

Citations

  • Shows this code’s PFS status (B). Result: Bundled / not separately paid.

    Physician relative value file (PPRRVU)CMS RVU13AJanuary 1 – March 31, 2013revision 2

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    PPRRVU13_V1226_UP0.csv row 15,608 in rvu13ar.zip

    In the CMS file

    Loading rows 15,606–15,610 of PPRRVU13_V1226_UP0.csv…

    Download rvu13ar.zip from CMS File fingerprint 79b1988bb9cbab6a61634b6463d26ce88cca431c3e36fa3b73792f29882d95b4

Plain-text summaryReport a problem

CPT 99489 has no published national rate. It carries status B (bundled) in the Q1 2013 release. Medicare folds payment for this code into the service it is incident to, never onto its own line. The blank amount means unpriced, not $0.

Why is there no national PFS amount for 99489?

Its status indicator is B (bundled). Medicare folds payment for this code into the service it is incident to, never onto its own line. Status B is not separately payable under the PFS.

Which billing rules and modifiers apply? Copy link

Payment rules for 99489 Copy link

Other payment indicators (10)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Not determined, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Why would a Medicare claim for 99489 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is B (bundled)—Medicare folds payment for this code into the service it is incident to, never onto its own line. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

Global period: what 99489's fee already covers Copy link

ZZZ Add-on code

This code is always billed alongside another service and carries no follow-up period of its own. The primary procedure's global period governs; this indicator does not determine whether either line is payable.

Can you bill it with another code? Copy link

Check a pair of codes Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.

See every current NCCI pair for 99489 →

Why a 99489 line may not pay separately Copy link

CMS publishes no separately payable amount for 99489 in this release, so reconciling the line means establishing which status governed the date of service rather than chasing a fee-schedule difference.

What to check

  • Confirm the status that governed the date of service before working this line as a short payment—CMS publishes no separately payable fee-schedule amount for it in this release.
  • Reconcile this line together with the primary procedure on the same claim—it is an add-on that is never billed alone and carries no global period of its own.
  • Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.

Compare against 99487, 99486 and 99485: their amounts are in Related codes.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04).

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 99489 across quarterly releases. +66.3% increase since Q1 2017 · peak $78.16 in Q1 2026

Q1 2017 · $47.01 Q2 2017 · $47.01 (0.0%) Q3 2017 · $47.01 (0.0%) Q4 2017 · $47.01 (0.0%) Q1 2018 · $47.16 (+0.3%) Q2 2018 · $47.16 (0.0%) Q3 2018 · $47.16 (0.0%) Q4 2018 · $47.16 (0.0%) Q1 2019 · $46.49 (-1.4%) Q2 2019 · $46.49 (0.0%) Q3 2019 · $46.49 (0.0%) Q4 2019 · $46.49 (0.0%) Q1 2020 · $44.75 (-3.7%) Q2 2020 · $44.75 (0.0%) Q3 2020 · $44.75 (0.0%) Q4 2020 · $44.75 (0.0%) Q1 2021 · $43.97 (-1.7%) Q2 2021 · $43.97 (0.0%) Q3 2021 · $43.97 (0.0%) Q4 2021 · $43.97 (0.0%) Q1 2022 · $70.60 (+60.6%) Q2 2022 · $70.60 (0.0%) Q3 2022 · $70.60 (0.0%) Q4 2022 · $70.60 (0.0%) Q1 2023 · $70.49 (-0.2%) Q2 2023 · $70.49 (0.0%) Q3 2023 · $70.49 (0.0%) Q4 2023 · $70.49 (0.0%) Q1 2024 · $71.05 (+0.8%) Q1 2024 · $72.23 (+1.7%) Q2 2024 · $72.23 (0.0%) Q3 2024 · $72.23 (0.0%) Q4 2024 · $72.23 (0.0%) Q1 2025 · $70.52 (-2.4%) Q2 2025 · $70.52 (0.0%) Q3 2025 · $70.52 (0.0%) Q4 2025 · $70.52 (0.0%) Q1 2026 · $78.16 (+10.8%) Q2 2026 · $78.16 (0.0%) Q3 2026 · $78.16 (0.0%) Q4 2026 · $78.16 (0.0%)
Office (non-facility) Facility
Release Status Office Facility
Q4 2026 Oct 1, 2026 – present A $78.16 (0.0% no change) $43.76 (0.0% no change)
When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

The 99489 rate last moved in Q1 2026. See its rate history.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Usage and related codes Copy link

How often 99489 is billed Copy link

Across Original Medicare in CY2024, 99489 ranked #220 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 10.7 times on average that year.

Beneficiaries
134,350
Office + facility beneficiaries combined
Services
1.4M
Times it was billed
Allowed
$96.2M
Total Medicare allowed dollars
Compare: ↑ #219 more popular · 70496 ↓ #221 less popular · 74183

2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q1 2013 fee schedule above.

Who bills 99489 to Medicare

Observed CY2024 Medicare fee-for-service billing, by the rendering clinician's CMS specialty. Each share is that specialty's slice of all observed services for this code that year.

Internal Medicine
34%
NP/PA
26%
Family Medicine
22%
Pain Medicine
2%
Cardiology
2%

Setting split that year: 96% Office (non-facility) · 4% facility. CMS publishes only this facility vs non-facility split, never the exact place of service. The Office (non-facility) figure does not identify urgent care or any other specific setting.

CY2024 Medicare fee-for-service only, from the CMS Physician & Other Practitioners dataset, which suppresses rows under 11 beneficiaries. We omit specialty groups with fewer than 30 observed clinicians, so the shares can fall short of 100%. Specialty and practice-type pages linked elsewhere on this page are curated code lists, not utilization claims.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q1 2013 release (effective January 2013). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.

Physician relative value file (Q1 2013) · rvu13ar.zip (PPRRVU13_V1226_UP0.csv row 15,608)

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 99489 National PFS baseline: No national PFS rate (Q1 2013; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU13A, PPRRVU13_V1226_UP0.csv row 15,608. Localis. https://localishealth.com/cpt/99489/2013/A