# CPT 99490

> Medicare paid $42.84 for CPT 99490 in the office (non-facility) setting and $32.76 in a facility under the Q1 2018 Physician Fee Schedule, effective January 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.3% increase from the previous quarter.

## 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: Q1 2018 (2018 A)
- Effective: January 1 – March 31, 2018
- Status indicator: A
- Office (non-facility) national allowed amount: $42.84
- Facility national allowed amount: $32.76
- Sequestration: not applied

## RVUs and formula

- Work RVU: 0.61
- Office (non-facility) practice expense RVU: 0.54
- Facility practice expense RVU: 0.26
- Malpractice RVU: 0.04
- Conversion factor: 35.9996
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2018)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18ar1.zip
- Parsed file: PPRRVU18_JAN.csv, row 16,622
- Canonical page: https://localishealth.com/cpt/99490/2018/A
- Release-specific citation URL: https://localishealth.com/cpt/99490/2018/A
- Last significant update: 2026-08-04T03:08:09+00:00