Resources for care teams
By MySeema · Published November 10, 2026
The codes Medicare uses to pay for care management, remote monitoring, behavioral health integration, and navigation, with what each one covers and its national office benchmark.
Medicare pays for care management through separate code families: Chronic Care Management (99490, 99439, 99487, 99489, 99491, 99437), Transitional Care Management (99495, 99496), Principal Care Management (99424 to 99427), Advanced Primary Care Management (G0556 to G0558), Remote Patient Monitoring, Remote Therapeutic Monitoring, Behavioral Health Integration, Community Health Integration (G0019, G0022), and Principal Illness Navigation (G0023, G0024, G0140, G0146).
2026 Medicare allowed amounts, national office/nonfacility benchmark, non-QP conversion factor. Includes applicable patient cost sharing; before practice costs and MySeema fees. Actual collections vary with location, setting, clinician, coverage, and claim adjustments. Each amount below is read from the program page it links to.
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| 99490 | Clinical staff: 20+ minutes / month | $66.13 / patient month |
| 99439 | Clinical staff: Each additional 20 minutes | $50.44 / additional 20 min |
| 99487 | Complex CCM: 60+ minutes / month | $144.29 / patient month |
| 99489 | Complex CCM: Each additional 30 minutes | $78.16 / additional 30 min |
| 99491 | Clinician personally: 30+ minutes / month | $89.18 / patient month |
| 99437 | Clinician personally: Each additional 30 minutes | $63.13 / additional 30 min |
CCM guide · CCM support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| 99495 | Moderate complexity: Clinical visit within 14 days | $220.11 / qualifying transition |
| 99496 | High complexity: Clinical visit within 7 days | $298.60 / qualifying transition |
TCM guide · TCM support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| 99426 | Clinical staff: First 30 minutes / month | $67.80 / patient month |
| 99427 | Clinical staff: Each additional 30 minutes | $54.11 / additional 30 min |
| 99424 | Clinician personally: First 30 minutes / month | $87.51 / patient month |
| 99425 | Clinician personally: Each additional 30 minutes | $61.46 / additional 30 min |
PCM guide · PCM support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| G0556 | Primary-care relationship: Qualifying APCM services | $16.37 / patient month |
| G0557 | Multiple chronic conditions: 2+ qualifying chronic conditions | $53.78 / patient month |
| G0558 | QMB + chronic conditions: QMB status + 2+ qualifying conditions | $117.24 / patient month |
APCM guide · APCM support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| 99453 | Device setup & readings: Initial setup and instruction | $21.71 / initial setup |
| 99445 | Device setup & readings: 2–15 transmission days | $52.11 / 30-day period |
| 99454 | Device setup & readings: 16–30 transmission days | $52.11 / 30-day period |
| 99470 | Monitoring management: 10–19 minutes | $26.05 / patient month |
| 99457 | Monitoring management: First 20 minutes | $51.77 / patient month |
| 99458 | Monitoring management: Each additional 20 minutes | $41.42 / additional 20 min |
RPM guide · RPM support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| 98975 | Device support: Initial setup and instruction | $21.71 / initial setup |
| 98984 / 98976 | Device support: Respiratory: 2–15 / 16–30 data days | $52.11 / 30-day period |
| 98985 / 98977 | Device support: Musculoskeletal: 2–15 / 16–30 data days | $51.44 / 30-day period |
| 98986 / 98978 | Device support: Cognitive behavioral: contractor-priced | Contractor-priced No national rate |
| 98979 | Therapy management: 10–19 minutes | $26.39 / patient month |
| 98980 | Therapy management: First 20 minutes | $54.11 / patient month |
| 98981 | Therapy management: Each additional 20 minutes | $41.42 / additional 20 min |
RTM guide · RTM support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| 99484 | General BHI: 20+ qualifying staff minutes / month | $57.45 / patient month |
| G0323 | General BHI: Specified psychologist / social-worker pathway | $57.78 / patient month |
| 99492 | Psychiatric collaborative care: Initial month: 70 minutes | $160.32 / patient month |
| 99493 | Psychiatric collaborative care: Following month: 60 minutes | $144.96 / patient month |
| 99494 | Psychiatric collaborative care: Each additional 30 minutes | $61.46 / additional 30 min |
| G2214 | Psychiatric collaborative care: Shorter initial / following month | $60.79 / patient month |
BHI guide · BHI support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| G0019 | Community support: First 60 minutes / month | $86.17 / patient month |
| G0022 | Community support: Each additional 30 minutes | $54.11 / additional 30 min |
CHI guide · CHI support and estimator
| Code | Covers | 2026 national office benchmark |
|---|---|---|
| G0023 | Illness navigation: First 60 minutes / month | $87.18 / patient month |
| G0024 | Illness navigation: Each additional 30 minutes | $54.44 / additional 30 min |
| G0140 | Peer-support pathway: First 60 minutes / month | $89.18 / patient month |
| G0146 | Peer-support pathway: Each additional 30 minutes | $53.44 / additional 30 min |
PIN guide · PIN support and estimator
Sometimes, and only for distinct work. The same practitioner must not bill APCM together with CCM, PCM, or TCM for the same patient and month. RPM and RTM cannot be billed together for the same patient over an overlapping period. Other combinations require that every requirement of each service is met and that no time or work is counted twice. Confirm with your billing team.
The benchmarks on this page are 2026 amounts. Medicare’s 2027 conversion factor is lower ($32.63 for most clinicians, down 2.31%), so 2027 payment amounts will differ. Remote monitoring also has new rules for starting and staffing the service. Read what the 2027 fee schedule changes.
This page is a planning reference. It is not a billing manual or a promise of reimbursement.
Discuss the population and workflow you want to support, the responsibilities your team would retain, and the next steps for a proposed scope.