{
    "code": "99490",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99490/2022/A",
    "release_specific_url": "https://localishealth.com/cpt/99490/2022/D",
    "description": "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.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99490 in Q4 2022?",
        "text": "Medicare paid $64.02 for CPT 99490 in the office (non-facility) setting and $51.56 in a facility under the Q4 2022 Physician Fee Schedule, effective October 2022. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2022, when it increased 55.5%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2022,
        "quarter": "D",
        "label": "Q4 2022",
        "effective": "October 1 – December 31, 2022",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 64.02,
        "facility": 51.56,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1,
        "practice_expense_non_facility": 0.78,
        "practice_expense_facility": 0.42,
        "malpractice": 0.07
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.6062,
    "source": {
        "label": "Physician relative value file (Q4 2022)",
        "cms_url": "https://www.cms.gov/files/zip/rvu22d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2022/D",
        "file": "PPRRVU22_OCT.csv",
        "row": 17709,
        "sha256": "f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab"
    },
    "modified_at": "2026-08-04T03:12:03+00:00"
}