CPT 99487
Description, Billing Rules, and Use Cases
CPT 99487 is the base billing code for Complex Chronic Care Management (CCCM) services that require at least 60 minutes of clinical staff time in a calendar month.
It is used when care is provided under the direction of a physician or other qualified healthcare professional and involves moderate to high complexity medical decision-making.
CPT 99487 reflects the first hour of time spent managing patients with multiple chronic conditions — and is the foundational code that must be billed before any add-on time (e.g. CPT 99489) can be reported.
What is CPT Code 99487?
CPT 99487 is used to bill for the first 60 minutes of Complex Chronic Care Management (CCCM) services provided by clinical staff under physician supervision in a given calendar month.
These services are delivered to patients with two or more chronic conditions that place them at significant risk of death, acute decompensation, or functional decline.
Use CPT 99487 when all of the following are true:
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The patient has 2+ chronic conditions expected to last at least 12 months or until death
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The conditions pose significant health risk or contribute to clinical instability
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A comprehensive care plan has been established and is actively maintained
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Medical decision-making is of moderate or high complexity
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A minimum of 60 minutes of qualifying clinical staff time is documented
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Services are directed by a physician or other qualified healthcare professional
CPT 99487 is the required base code for CCCM. If more than 90 minutes of care is provided in a month, you may also bill CPT 99489 for each additional 30-minute block.
CPT 99487 Billing Requirements and Eligibility
CPT 99487 is the foundational billing code for Complex Chronic Care Management (CCCM). It must be supported by specific patient conditions, care planning activities, and a minimum threshold of clinical staff time each calendar month.
Patient Eligibility Criteria
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The patient must have two or more chronic conditions which:
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Are expected to last at least 12 months, or until the patient’s death
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Place the patient at significant risk of death, decompensation, or functional decline
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A comprehensive care plan must be:
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Established, implemented, revised, or monitored during the billing period
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Documented in the medical record
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Shared with the patient and/or caregiver when appropriate
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Provider Requirements
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CPT 99487 must be billed by a physician, nurse practitioner, or physician assistant
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Services must be delivered by clinical staff under the supervision of the billing provider
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The billing provider must assume overall care management responsibility for the patient that month
Service Requirements
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At least 60 minutes of non-overlapping, documented clinical staff time must be provided in the calendar month
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Medical decision-making must be of moderate or high complexity
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Services may not be duplicated or reported with other overlapping care management codes (e.g., 99490, 99491, 99484)
CPT 99487 Billing Documentation Checklist
To ensure clean claims and full compliance, make sure the following documentation is included when billing CPT 99487:
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At least 60 minutes of clinical staff time delivered during the calendar month
(Include time logs or EHR entries with exact dates, activities, and total minutes) -
A clearly identified care team directed by a physician, NP, or PA
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A comprehensive care plan that was:
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Established, implemented, revised, or monitored during the billing period
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Addressed all relevant chronic conditions
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Shared with the patient and/or caregiver as appropriate
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Stored in the patient’s medical record
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Medical decision-making documented as moderate or high complexity
(e.g., medication changes, coordination with specialists, or managing clinical instability) -
Time is non-overlapping with other billed services, including:
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CPT 99490 (standard CCM)
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CPT 99491 (physician-delivered CCM)
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Principal Care Management (99424–99427)
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Behavioral Health Integration (99484)
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Transitional Care Management (99495–99496)
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Only clinical staff time is counted — not provider time
(Unless that provider time is separately billed under a different code)
CPT 99487 Time Thresholds and Code Combinations
CPT 99487 is billed for the first 60 minutes of Complex Chronic Care Management services delivered by clinical staff under provider supervision. If more time is spent, CPT 99489 is used to report each additional 30-minute increment.
Use the following chart to determine the correct billing combination based on total clinical staff time:
Key Reminders:
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CPT 99487 must always be billed before 99489
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Time must be documented accurately and not overlap with other CCM, PCM, or behavioral health codes
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Only clinical staff time directed by a provider counts toward thresholds
When to Use CPT 99487:
Common Scenarios and Use Cases
CPT 99487 is the correct code to use when your care team provides at least 60 minutes of qualifying Complex Chronic Care Management (CCCM) services in a billing month. These services must be delivered by clinical staff under provider supervision and involve moderate or high complexity medical decision-making.
Here are examples of how CPT 99487 is used in practice:
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Managing Polypharmacy + CHF
A care team supports a patient with congestive heart failure and chronic kidney disease through:-
Monthly medication reconciliation
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Coordination with cardiology and nephrology
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Patient education and symptom monitoring
Total qualifying time: 75 minutes
Billing: 99487
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Post-Hospital Care Coordination
A nurse-led team provides support for a high-risk diabetic patient post-discharge, including:-
Care plan updates
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Transition coordination with home health
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Medication and nutrition management
Total qualifying time: 90 minutes
Billing: 99487 + 99489
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Assisted Living Chronic Care Planning
A clinical team manages care for an elderly patient with cognitive impairment and multiple chronic conditions. Services include:-
Frequent communication with caregivers and facility staff
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Routine check-ins and symptom assessments
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Adjustments to care plan based on behavior and mobility changes
Total qualifying time: 120 minutes
Billing: 99487 + 99489 ×2
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Common CPT 99487 Billing Mistakes
(and How to Avoid Them)
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❌ Billing 99487 for Less Than 60 Minutes
CPT 99487 requires at least 60 minutes of qualifying clinical staff time in a calendar month. Anything less is not billable, even if moderate or high complexity decision-making is involved.
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❌ Using 99487 With Low-Complexity Cases
This code may only be used when the patient’s case involves moderate or high complexity medical decision-making. Cases that involve low-complexity care should instead be considered for CPT 99490, if time thresholds are met.
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❌ Overlapping Time With Other Care Management Codes
You may not bill CPT 99487 if the same time period is already being reported under other codes, including:-
CPT 99490 or 99491 (standard CCM)
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Principal Care Management (99424–99427)
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Behavioral Health Integration (99484, 99492–99494)
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Transitional Care Management (99495–99496)
Only non-overlapping clinical staff time can be applied toward CPT 99487.
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❌ Missing or Incomplete Documentation
Your records must clearly show:-
That at least 60 minutes of clinical staff time occurred
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What tasks were completed
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On which dates and by whom
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That a care plan was actively managed
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That moderate/high complexity decision-making was involved
Vague or missing documentation can result in claim denials or audits.
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❌ Counting Provider Time Instead of Staff Time
Only clinical staff time under physician or NP supervision counts toward 99487. Provider time (unless billed separately under another code) does not contribute to the required 60-minute threshold.