Chronic Care Management (CCM)
How CCM codes 99490, 99439, 99491, 99437, 99487, and 99489 work in Vantrexia, and how CCM minutes stay separate from RPM minutes.
Chronic Care Management pays for non-face-to-face care coordination for patients with two or more chronic conditions. Vantrexia tracks CCM time alongside RPM time and generates the billing entries from attested notes.
The code families
CCM splits into three ladders depending on who does the work and how complex the case is.
Staff-performed, non-complex
| Code | Time | Cap |
|---|---|---|
| 99490 | First 20 minutes of clinical staff time | Once per patient per month |
| 99439 | Each additional 20 minutes | Maximum 2 units |
That gives a billable ceiling of 60 minutes per month. Staff may log more time than that for audit purposes, but add-on units stop increasing.
Provider-performed
| Code | Time |
|---|---|
| 99491 | First 30 minutes of physician or qualified provider time |
| 99437 | Each additional 30 minutes |
CMS publishes no hard cap on 99437 units. Vantrexia keeps emitting add-ons as cumulative minutes cross each new 30-minute boundary.
Complex CCM
| Code | Time |
|---|---|
| 99487 | First 60 minutes |
| 99489 | Each additional 30 minutes |
Also uncapped in published CMS guidance.
RPM and CCM minutes do not mix
This is the rule that prevents the most expensive billing error in the platform, so it is worth understanding.
Minutes that are already funding a CCM code are excluded from the RPM cumulative-minute total. Without that exclusion, a five-minute RPM call on a patient who already had CCM time logged could push the period past the 20-minute RPM threshold and bill a 99457 on five minutes of actual RPM work. That claim would be wrong.
Do not log the same minutes against both programs. The platform separates them, but only if the time is recorded against the correct program in the first place.
Diagnoses
CCM requires two or more qualifying chronic conditions on file. Vantrexia holds diagnoses as structured records linked to the patient, and the enrollment flow will flag patients who look eligible but lack the diagnoses to support a claim.
The monthly rollup
Attested notes roll up once per patient, per period, per variant (RPM, CCM, or combined) into a payer-formatted monthly note. That rollup is what creates the CCM time logs and billing entries.
Voiding an entry is a human decision not to bill it. Nothing that runs on a schedule will resurrect a voided entry.