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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 99487
  4. Cost Analysis

How Much Does 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 Cost on Medicare?

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

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Average Medicare Payment

$92.93

2023 data

Total Payments (2023)

$42.5M

Services (2023)

445.7K

Price Change (2017–2023)

+37.7%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2017$67.49$7.6M109.9K—
2018$67.65$13.8M197.6K+0.2%
2019$67.83$18.3M263.5K+0.3%
2020$67.76$18.3M266.0K-0.1%
2021$67.27$17.4M253.3K-0.7%
2022$94.65$29.4M300.2K+40.7%
2023$92.93$42.5M445.7K-1.8%

🗺️ State-by-State Cost Variation

The most expensive state pays 2.2x more than the cheapest for this procedure. AK averages $124.26 vs WV at $57.28.

StateAvg PaymentTotal PaymentsServicesProviders
AK$124.26$30.7K2473
DC$111.14$220.6K2.0K7
UT$109.18$1.1M10.3K14
NY$107.68$1.9M17.6K144
RI$107.16$15.8K1472
CA$103.75$4.9M47.7K216
DE$103.24$136.3K1.3K13
WY$102.22$38.2K3743
NJ$100.51$1.9M19.0K79
CO$99.41$289.7K2.9K57
PA$98.86$1.0M10.6K99
MD$98.37$928.4K9.4K51
VA$97.97$338.3K3.5K85
GA$97.80$2.4M24.9K104
IL$97.14$1.3M13.6K66
NV$96.69$771.4K8.0K63
TX$96.62$7.6M78.3K263
CT$96.28$300.9K3.1K35
OR$95.83$82.6K8627
OK$94.97$492.5K5.2K10
MT$94.89$16.3K1726
MI$94.89$1.4M15.1K95
IN$94.85$590.8K6.2K32
MA$94.71$286.8K3.0K54
KY$94.52$116.0K1.2K15
NH$94.18$32.7K3474
FL$93.94$4.2M44.6K271
NM$93.45$38.1K40816
AZ$93.06$337.9K3.6K49
LA$92.44$601.7K6.5K38
NE$92.04$106.6K1.2K14
MO$92.04$136.8K1.5K9
NC$91.89$808.3K8.8K113
HI$90.28$46.3K5132
AR$90.18$163.2K1.8K27
TN$90.03$362.1K4.0K47
MN$89.93$141.8K1.6K20
OH$88.77$272.8K3.1K42
KS$87.77$93.0K1.1K12
WA$86.89$145.2K1.7K23
WI$86.74$264.6K3.0K13
MS$86.37$150.8K1.7K37
SC$83.36$5.5M66.1K352
AL$80.95$485.9K6.0K52
ID$79.76$204.8K2.6K24
WV$57.28$42.8K74710

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Tao HoInternal MedicineTX$1.3M12.9K$99.33
Amer HomsiInternal MedicineUT$1.0M9.3K$112.01
Amar MohanInternal MedicineGA$807.7K7.8K$103.71
Danny BartelNeurologyTX$590.7K6.1K$97.17
Joel WaldropEmergency MedicineSC$496.4K5.1K$96.43
Nhue HoInternal MedicineTX$485.6K5.0K$96.93
Yael MillerGeriatric MedicineNJ$392.9K3.6K$110.29
Steven KatzmanInternal MedicineMI$372.8K3.8K$97.51
Andrew DonatoEmergency MedicineSC$351.2K3.6K$98.90
Zachary LipmanAnesthesiologyCA$348.1K3.2K$107.21
William CraigCardiologyTX$329.5K3.4K$98.23
Ryan PickellInternal MedicineIN$299.6K3.1K$97.61
Keino RutherfordInternal MedicineCA$286.9K3.9K$73.68
Shawna MurphyFamily PracticePA$275.1K2.6K$105.65
Arvid LadeInternal MedicineOK$273.3K2.9K$94.48
Kenneth BeckerHospitalistSC$270.7K2.8K$97.15
Nakizito KazigoInternal MedicineTX$270.1K2.6K$102.28
Christine ContrerasInternal MedicineTX$261.6K3.0K$87.99
Jay SchapiraCardiologyCA$235.4K2.0K$117.90
Jillian SmithEmergency MedicineNJ$221.4K2.0K$108.26

🤔 Is 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 Overpriced?

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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.