How much does Medicare pay for CPT 99439?

Medicare allowed an average of $46.13 per service and paid $36.02 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $97.02, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does 99439 pay differently in an office than a hospital?

Yes. The allowed amount averaged $46.44 in an office setting and $32.09 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 99439 most?

Internal Medicine, with 689,277 services from 2,214 clinicians. Next are Family Practice, Geriatric Medicine, Nurse Practitioner.

CPT 99439

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month

$46.13Medicare-allowed amount per service, averaged across 2,958,539 services

Providers submitted

$97.02

Asking price, not received

Medicare allowed

$46.13

The fee schedule figure

Medicare paid

$36.02

Balance is patient coinsurance

Providers submitted an average of $97.02 for this code and Medicare allowed $46.13 — 2.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $36.02 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $46.44
Hospital / facility: $32.09

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,894,775 services were billed in an office setting and 63,764 in a facility.

Services: 2,958,539
Beneficiaries: 757,703
Providers billing it: 10,926
Total allowed: $136,477,404

What Medicare pays for CPT 99439

Across 2,958,539 services billed by 10,926 providers to 757,703 beneficiaries, Medicare allowed an average of $46.13 per service. That is 3.9 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 99439

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	689,277	178,459	$47.57	2,214
Family Practice	471,187	120,160	$45.99	2,283
Geriatric Medicine	385,863	99,111	$47.78	42
Nurse Practitioner	382,103	118,856	$39.73	2,222
Cardiology	204,460	35,107	$48.48	393
Gastroenterology	201,685	23,027	$47.38	482
Nephrology	122,613	30,846	$47.32	685
Physician Assistant	108,968	35,083	$39.99	507
Urology	107,772	42,007	$48.01	934
Emergency Medicine	48,399	12,998	$50.32	59
Interventional Cardiology	29,238	7,012	$48.27	113
Pulmonary Disease	25,219	6,753	$46.85	126
Physical Medicine and Rehabilitation	23,471	6,845	$45.79	71
General Practice	22,213	5,117	$48.37	66
Neurology	18,633	4,394	$49.76	75

99439 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Connecticut	411,535	$48.26	$37.04	83
California	314,104	$50.59	$36.36	768
Texas	229,293	$45.42	$36.06	1,063
New York	201,656	$48.41	$34.76	558
Florida	190,341	$44.87	$34.96	701
North Carolina	124,819	$42.43	$34.41	545
Pennsylvania	104,724	$43.81	$34.29	439
Georgia	102,315	$44.23	$35.60	411
Arizona	91,437	$44.88	$35.46	389
Missouri	88,989	$46.27	$36.87	139
New Jersey	81,307	$51.11	$36.14	366
Tennessee	73,898	$43.51	$35.21	263
Virginia	70,498	$46.42	$35.52	402
Illinois	69,410	$46.15	$35.08	423
Nevada	62,514	$46.18	$36.19	144
Indiana	56,671	$42.79	$34.89	286
Michigan	55,270	$45.48	$35.40	300
Maryland	55,059	$46.64	$34.28	218
Alabama	55,028	$43.83	$36.47	259
Kentucky	48,532	$43.46	$35.95	167
South Carolina	46,346	$44.02	$34.90	420
Louisiana	42,353	$43.43	$35.16	227
Colorado	38,732	$45.54	$35.01	265
Ohio	38,475	$42.41	$34.07	273
Massachusetts	32,081	$48.14	$35.16	181
Mississippi	31,561	$42.84	$35.56	188
Arkansas	26,626	$42.58	$36.05	81
Nebraska	21,310	$42.01	$34.12	116
Kansas	20,799	$43.46	$35.58	162
Washington	18,046	$45.17	$34.19	82
Delaware	17,569	$46.42	$36.14	64
Iowa	16,567	$43.12	$35.25	231
Oklahoma	15,006	$43.61	$35.61	117
New Mexico	13,901	$41.09	$33.36	114
Idaho	13,752	$39.60	$32.57	63
West Virginia	13,361	$38.33	$30.75	69
Oregon	11,685	$46.87	$36.24	32
Rhode Island	7,671	$43.67	$33.39	20
Wisconsin	7,110	$43.93	$35.80	57
Utah	6,867	$41.88	$33.83	47
District of Columbia	5,177	$48.50	$34.83	21
New Hampshire	5,037	$42.70	$32.22	15
Minnesota	3,977	$41.84	$31.99	50
Wyoming	3,157	$43.41	$34.48	22
Maine	2,893	$43.72	$35.50	13
North Dakota	2,889	$37.08	$29.25	13
Alaska	2,627	$57.67	$36.19	16
Hawaii	2,317	$47.14	$34.90	7
South Dakota	1,008	$44.23	$35.62	7
Montana	952	$43.57	$34.67	18
Guam	702	$50.52	$35.38	4
Vermont	253	$45.68	$34.23	4
U.S. Virgin Islands	202	$47.17	$37.27	1
Puerto Rico	130	$44.43	$37.49	2

Related codes

99490Chronic care management services$59.70
99497Advance care planning$73.95
99457Management using the results of remote vital sign monitoring per calen$48.61
99458Management using the results of remote vital sign monitoring per calen$39.11
99454Remote monitoring of physiologic parameters$47.97
99489Complex chronic care management services for two or more chronic condi$67.00
99442Telephone medical discussion$83.84
99443Telephone medical discussion$120.39
99487Complex chronic care management services for two or more chronic condi$124.70
99496Transitional care management services for problem of high complexity$252.87
99426Principal care management services for a single high-risk disease$60.08
99484Care management services for behavioral health conditions$50.05

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.