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These codes overlap, and several cannot be billed by the same practitioner for the same patient and month. Use this page to find the right guide, then confirm current rules and rates in the CMS Physician Fee Schedule search.
Advanced Primary Care Management
| Codes | Service | Billing basis |
|---|---|---|
| G0556 · G0557 · G0558 | APCM levels 1 to 3 · APCM codes guide | Monthly, tiered by conditions and QMB status |
| G0568 · G0569 · G0570 | Behavioral health add-ons to APCM · BHI add-ons | Monthly, with an APCM base code |
Other care management
| Codes | Service | Billing basis |
|---|---|---|
| 99490 · 99439 | Chronic Care Management, clinical staff · APCM vs. CCM | 20 minutes, then each additional 20 |
| 99491 · 99437 | Chronic Care Management, practitioner | 30 minutes, then each additional 30 |
| 99487 · 99489 | Complex Chronic Care Management | 60 minutes, then each additional 30 |
| 99424 to 99427 | Principal Care Management · APCM vs. PCM | 30-minute increments, one high-risk condition |
| 99495 · 99496 | Transitional Care Management · APCM vs. TCM | 30-day episode after discharge |
Behavioral health (standalone)
| Codes | Service | Billing basis |
|---|---|---|
| 99484 | General behavioral health integration | 20 minutes |
| 99492 · 99493 · 99494 | Psychiatric Collaborative Care Model | Time-based, first and subsequent months |
Preventive visits
| Codes | Service | Billing basis |
|---|---|---|
| G0402 · G0438 · G0439 | Welcome to Medicare, initial AWV, subsequent AWV · AWV guide | Once or yearly, by visit type |