Cost analysis for CPT 99487 — Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month
Average Medicare Payment
$92.93
2023 data
Total Payments (2023)
$42.5M
Services (2023)
445.7K
Price Change (2017–2023)
+37.7%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2017 | $67.49 | $7.6M | 109.9K | — |
| 2018 | $67.65 | $13.8M | 197.6K | +0.2% |
| 2019 | $67.83 | $18.3M | 263.5K | +0.3% |
| 2020 | $67.76 | $18.3M | 266.0K | -0.1% |
| 2021 | $67.27 | $17.4M | 253.3K | -0.7% |
| 2022 | $94.65 | $29.4M | 300.2K | +40.7% |
| 2023 | $92.93 | $42.5M | 445.7K | -1.8% |
The most expensive state pays 2.2x more than the cheapest for this procedure. AK averages $124.26 vs WV at $57.28.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $124.26 | $30.7K | 247 | 3 |
| DC | $111.14 | $220.6K | 2.0K | 7 |
| UT | $109.18 | $1.1M | 10.3K | 14 |
| NY | $107.68 | $1.9M | 17.6K | 144 |
| RI | $107.16 | $15.8K | 147 | 2 |
| CA | $103.75 | $4.9M | 47.7K | 216 |
| DE | $103.24 | $136.3K | 1.3K | 13 |
| WY | $102.22 | $38.2K | 374 | 3 |
| NJ | $100.51 | $1.9M | 19.0K | 79 |
| CO | $99.41 | $289.7K | 2.9K | 57 |
| PA | $98.86 | $1.0M | 10.6K | 99 |
| MD | $98.37 | $928.4K | 9.4K | 51 |
| VA | $97.97 | $338.3K | 3.5K | 85 |
| GA | $97.80 | $2.4M | 24.9K | 104 |
| IL | $97.14 | $1.3M | 13.6K | 66 |
| NV | $96.69 | $771.4K | 8.0K | 63 |
| TX | $96.62 | $7.6M | 78.3K | 263 |
| CT | $96.28 | $300.9K | 3.1K | 35 |
| OR | $95.83 | $82.6K | 862 | 7 |
| OK | $94.97 | $492.5K | 5.2K | 10 |
| MT | $94.89 | $16.3K | 172 | 6 |
| MI | $94.89 | $1.4M | 15.1K | 95 |
| IN | $94.85 | $590.8K | 6.2K | 32 |
| MA | $94.71 | $286.8K | 3.0K | 54 |
| KY | $94.52 | $116.0K | 1.2K | 15 |
| NH | $94.18 | $32.7K | 347 | 4 |
| FL | $93.94 | $4.2M | 44.6K | 271 |
| NM | $93.45 | $38.1K | 408 | 16 |
| AZ | $93.06 | $337.9K | 3.6K | 49 |
| LA | $92.44 | $601.7K | 6.5K | 38 |
| NE | $92.04 | $106.6K | 1.2K | 14 |
| MO | $92.04 | $136.8K | 1.5K | 9 |
| NC | $91.89 | $808.3K | 8.8K | 113 |
| HI | $90.28 | $46.3K | 513 | 2 |
| AR | $90.18 | $163.2K | 1.8K | 27 |
| TN | $90.03 | $362.1K | 4.0K | 47 |
| MN | $89.93 | $141.8K | 1.6K | 20 |
| OH | $88.77 | $272.8K | 3.1K | 42 |
| KS | $87.77 | $93.0K | 1.1K | 12 |
| WA | $86.89 | $145.2K | 1.7K | 23 |
| WI | $86.74 | $264.6K | 3.0K | 13 |
| MS | $86.37 | $150.8K | 1.7K | 37 |
| SC | $83.36 | $5.5M | 66.1K | 352 |
| AL | $80.95 | $485.9K | 6.0K | 52 |
| ID | $79.76 | $204.8K | 2.6K | 24 |
| WV | $57.28 | $42.8K | 747 | 10 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Tao Ho | Internal Medicine | TX | $1.3M | 12.9K | $99.33 |
| Amer Homsi | Internal Medicine | UT | $1.0M | 9.3K | $112.01 |
| Amar Mohan | Internal Medicine | GA | $807.7K | 7.8K | $103.71 |
| Danny Bartel | Neurology | TX | $590.7K | 6.1K | $97.17 |
| Joel Waldrop | Emergency Medicine | SC | $496.4K | 5.1K | $96.43 |
| Nhue Ho | Internal Medicine | TX | $485.6K | 5.0K | $96.93 |
| Yael Miller | Geriatric Medicine | NJ | $392.9K | 3.6K | $110.29 |
| Steven Katzman | Internal Medicine | MI | $372.8K | 3.8K | $97.51 |
| Andrew Donato | Emergency Medicine | SC | $351.2K | 3.6K | $98.90 |
| Zachary Lipman | Anesthesiology | CA | $348.1K | 3.2K | $107.21 |
| William Craig | Cardiology | TX | $329.5K | 3.4K | $98.23 |
| Ryan Pickell | Internal Medicine | IN | $299.6K | 3.1K | $97.61 |
| Keino Rutherford | Internal Medicine | CA | $286.9K | 3.9K | $73.68 |
| Shawna Murphy | Family Practice | PA | $275.1K | 2.6K | $105.65 |
| Arvid Lade | Internal Medicine | OK | $273.3K | 2.9K | $94.48 |
| Kenneth Becker | Hospitalist | SC | $270.7K | 2.8K | $97.15 |
| Nakizito Kazigo | Internal Medicine | TX | $270.1K | 2.6K | $102.28 |
| Christine Contreras | Internal Medicine | TX | $261.6K | 3.0K | $87.99 |
| Jay Schapira | Cardiology | CA | $235.4K | 2.0K | $117.90 |
| Jillian Smith | Emergency Medicine | NJ | $221.4K | 2.0K | $108.26 |
The data suggests significant pricing inconsistencies for CPT 99487. With a 2.2x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have risen 37.7% since 2017, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.