# CPT 99490

> Medicare paid $40.82 for CPT 99490 in the office (non-facility) setting and $31.51 in a facility under the Q3 2016 Physician Fee Schedule, effective July 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2016, when it decreased 5.3%.

## What it is

The first 20 minutes each calendar month of non-face-to-face care coordination by clinical staff for a patient with two or more chronic conditions expected to last at least a year (or until death) that place the patient at significant risk — for example, coordinating medication refills and specialist follow-up for a patient with diabetes and heart failure. Requires a documented care plan and the patient’s consent to enroll.

## Selected release

- Release: Q3 2016 (2016 C)
- Effective: July 1 – September 30, 2016
- Status indicator: A
- Office (non-facility) national allowed amount: $40.82
- Facility national allowed amount: $31.51
- Sequestration: not applied

## RVUs and formula

- Work RVU: 0.61
- Office (non-facility) practice expense RVU: 0.49
- Facility practice expense RVU: 0.23
- Malpractice RVU: 0.04
- Conversion factor: 35.8043
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q3 2016)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16c.zip
- Parsed file: PPRRVU16_V0517.csv, row 16,300
- Canonical page: https://localishealth.com/cpt/99490/2016/A
- Release-specific citation URL: https://localishealth.com/cpt/99490/2016/C
- Last significant update: 2026-08-04T03:06:56+00:00