CPT 99487 and 99489 are the complex chronic care management codes. They pay substantially more than standard CCM ($144.29 for 99487 in 2026, nationally, non facility, before geographic adjustment) because they require more: 60 minutes of clinical staff time instead of 20, and moderate to high complexity medical decision making performed personally by the billing…
CPT 99439 is the add on code for chronic care management: each additional 20 minutes of clinical staff time in a calendar month, after the first 20 minutes billed under CPT 99490. In 2026 it pays $50.44 nationally in the non facility setting, before geographic adjustment, and Medicare caps it at 2 units per date…
CPT 99490 is the base code for chronic care management (CCM): the first 20 minutes of clinical staff time spent each calendar month managing a patient with multiple chronic conditions, under the general supervision of the billing practitioner. In 2026 it pays $66.13 nationally in the non facility setting, before geographic adjustment. It is billable…
In the CY 2027 Medicare Physician Fee Schedule proposed rule, CMS proposed a change that would end outsourced staffing for remote monitoring. If finalized, remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) could only be billed when the work is performed by clinical staff directly employed by the billing practice, starting January 1, 2027….
What a medical practice employee handbook needs, the 9 sections that carry the weight, and the HIPAA document mix-up we found in our own clinic.
Whether to outsource medical billing is a make-or-buy decision, not a moral one. For most independent practices the honest answer turns on four things: your monthly claim volume, your payer mix, whether your revenue problem is actually a billing problem, and what the contract says about the day you want to leave. Here is the…
You reduce patient wait times by measuring where the delay actually happens, then fixing the schedule template, the daily workflow, and the no-show rate that feed it. Long waits are rarely one problem. They are the visible result of a schedule that does not match real demand, a clinic day with hidden bottlenecks, and small…
Compare the five ways to grow a medical practice by cost, speed, and complexity, and see what a second location requires that a new provider does not.
An MSO, or management services organization, is a company that runs the business side of a medical practice so the physicians can focus on care. It handles credentialing, payer contracting, human resources, compliance, technology, bookkeeping, and access to capital, usually under a written management services agreement. The physicians keep a separate clinical entity, a professional…
Direct primary care replaces insurance billing with a monthly membership. Seven questions on panel math, Medicare opt-out, state law and cash flow to answer before you convert.
