Digital, remote monitoring & care management

99490 - RVUs & Medicare payment (2026)

Chronic care management, clinical staff, first 20 minutes/month.

Component	Non-facility	Facility
Work RVU	1.00	1.00
Practice expense RVU	0.91	0.24
Malpractice RVU	0.07	0.07
Total RVUs	1.98	1.31
National payment (CF $33.4009)	$66.13	$43.76
Qualifying APM payment (CF $33.5675)	$66.46	$43.97

How 99490 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 99490 ranges from $60.71 in Arkansas (AR) to $83.76 in Alaska (AK); calculate 99490 for your locality.

Alaska (AK) $83.76 San Jose-Sunnyvale-Santa Clara (CA) $82.16 San Jose-Sunnyvale-Santa Clara (CA) $81.83 San Francisco-Oakland-Berkeley (CA) $80.50 San Francisco-Oakland-Berkeley (CA) $80.42 Napa (CA) $76.75 Vallejo (CA) $76.64 NYC Suburbs/Long Island (NY) $76.02 National average $66.13 … 97 more localities between … Rest Of Missouri (MO) $61.88 Alabama (AL) $61.32 Mississippi (MS) $61.30 Arkansas (AR) $60.71

Non-facility payment for 99490 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - digital, remote monitoring & care management

99421 · online digital e/m, 5-10 minutes over 7 days
99422 · online digital e/m, 11-20 minutes over 7 days
99423 · online digital e/m, 21+ minutes over 7 days
98966 · telephone assessment by qualified nonphysician, 5-10 minutes
98967 · telephone assessment by qualified nonphysician, 11-20 minutes
98968 · telephone assessment by qualified nonphysician, 21-30 minutes
99453 · remote physiologic monitoring, setup and patient education
99454 · remote physiologic monitoring, device supply per 30 days
99457 · remote physiologic monitoring management, first 20 minutes/month
99458 · remote physiologic monitoring management, each additional 20 minutes
98975 · remote therapeutic monitoring, setup and patient education
98977 · remote therapeutic monitoring, device supply per 30 days (musculoskeletal)
98980 · remote therapeutic monitoring management, first 20 minutes/month
98981 · remote therapeutic monitoring management, each additional 20 minutes
99439 · chronic care management, clinical staff, each additional 20 minutes
99491 · chronic care management by physician/qhp, first 30 minutes/month
99495 · transitional care management, moderate complexity (14-day contact)
99496 · transitional care management, high complexity (7-day contact)
99484 · general behavioral health integration care management, per month

Frequently asked questions

How much does Medicare pay for 99490 in 2026?

The national non-facility payment is $66.13 and the facility payment is $43.76, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 99490?

The 2026 work RVU for 99490 is 1.00. Total RVUs are 1.98 in the non-facility setting and 1.31 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.