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Procedure price report · Consultation, evaluation, and preventative care

Chronic care management by staff, 20 minutes a month

CPT 99490the billing code this page is about

Covers nurse or other clinical staff time coordinating care for a patient with two or more long-term conditions; one unit is at least 20 minutes in a calendar month.

Hospitals typically charge $88 cash for this outpatient procedure — the median across 862 hospitals that filed a usable cash price; the average of the middle 60% is $89. Most fall between $51 and $136 (20th–80th percentile).

Hospitals
862
States
49
Filings dated
Jan 2024 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 25, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 862 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$36$59$88$121$181

The most expensive tenth of hospitals charges at least 5.0× what the cheapest tenth charges ($36 vs $181).

How the prices are spread

$28 – $35: 46 hospitals$28$35 – $44: 47 hospitals$44 – $56: 65 hospitals$44$56 – $70: 110 hospitals$70 – $88: 119 hospitals$70$88 – $110: 138 hospitals$110 – $139: 145 hospitals$110$139 – $174: 61 hospitals$174 – $219: 25 hospitals$174$219 – $275: 25 hospitals$219median $88price bands are equal on a log scale
Hospitals per price band (781 of 862 — the bands cover the 5th to 95th percentile)
FromToHospitals
$28$3546
$35$4447
$44$5665
$56$70110
$70$88119
$88$110138
$110$139145
$139$17461
$174$21925
$219$27525

Against Medicare

Medicare pays (OPPS 2026, national rate)$104
Median cash price$88
Cash as a multiple of Medicare0.85×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $88.

Alaska: 4 hospitals filed a usable price — fewer than 10, so no figureAKMaine: median $46 across 14 hospitalsME$46Vermont: 5 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: 8 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $93 across 24 hospitalsWA$93Idaho: median $28 across 13 hospitalsID$28Montana: median $85 across 17 hospitalsMT$85North Dakota: median $132 across 12 hospitalsND$132Minnesota: median $103 across 31 hospitalsMN$103Illinois: median $83 across 38 hospitalsIL$83Wisconsin: median $113 across 40 hospitalsWI$113Michigan: median $63 across 39 hospitalsMI$63New York: median $109 across 50 hospitalsNY$109Massachusetts: 2 hospitals filed a usable price — fewer than 10, so no figureMAOregon: median $90 across 25 hospitalsOR$90Nevada: 3 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 8 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 7 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $115 across 38 hospitalsIA$115Indiana: median $74 across 36 hospitalsIN$74Ohio: median $133 across 28 hospitalsOH$133Pennsylvania: median $69 across 35 hospitalsPA$69New Jersey: median $102 across 13 hospitalsNJ$102Connecticut: 1 hospital filed a usable price — fewer than 10, so no figureCTRhode Island: 3 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $94 across 23 hospitalsCA$94Utah: 1 hospital filed a usable price — fewer than 10, so no figureUTColorado: median $90 across 22 hospitalsCO$90Nebraska: median $84 across 25 hospitalsNE$84Missouri: median $67 across 11 hospitalsMO$67Kentucky: 8 hospitals filed a usable price — fewer than 10, so no figureKYWest Virginia: median $94 across 26 hospitalsWV$94Virginia: median $87 across 19 hospitalsVA$87Maryland: 1 hospital filed a usable price — fewer than 10, so no figureMDDelaware: no hospital in the corpus filed a usable priceDEArizona: median $584 across 14 hospitalsAZ$584New Mexico: 5 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $65 across 27 hospitalsKS$65Arkansas: 3 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $43 across 12 hospitalsTN$43North Carolina: median $39 across 10 hospitalsNC$39South Carolina: 8 hospitals filed a usable price — fewer than 10, so no figureSCOklahoma: median $69 across 18 hospitalsOK$69Louisiana: median $65 across 11 hospitalsLA$65Mississippi: median $61 across 19 hospitalsMS$61Alabama: 4 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $146 across 21 hospitalsGA$146Hawaii: 7 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $72 across 55 hospitalsTX$72Florida: median $134 across 18 hospitalsFL$134
Cash price by state, most expensive first. National median $88. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Arizona AZ14$584+561%$77 – $584
Georgia GA21$146+65%$146 – $235
Florida FL18$134+52%$42 – $178
Ohio OH28$133+50%$58 – $415
North Dakota ND12$132+49%$110 – $168
Iowa IA38$115+30%$70 – $118
Wisconsin WI40$113+27%$78 – $138
New York NY50$109+24%$54 – $167
Minnesota MN31$103+16%$43 – $115
New Jersey NJ13$102+16%$101 – $109
West Virginia WV26$94+7%$53 – $104
California CA23$94+6%$42 – $270
Washington WA24$93+5%$79 – $121
Colorado CO22$90+2%$43 – $133
Oregon OR25$90+1%$81 – $134
Virginia VA19$87−2%$39 – $91
Montana MT17$85−3%$65 – $157
Nebraska NE25$84−5%$64 – $133
Illinois IL38$83−6%$35 – $134
Indiana IN36$74−16%$35 – $100
Texas TX55$72−19%$69 – $76
Oklahoma OK18$69−22%$69 – $111
Pennsylvania PA35$69−23%$33 – $120
Missouri MO11$67−24%$51 – $102
Louisiana LA11$65−26%$42 – $80
Kansas KS27$65−26%$41 – $102
Michigan MI39$63−29%$47 – $140
Mississippi MS19$61−31%$36 – $76
Maine ME14$46−48%$36 – $68
Tennessee TN12$43−51%$39 – $78
North Carolina NC10$39−56%$29 – $87
Idaho ID13$28−68%$28 – $73
Kentucky KY8not enough hospitals filed a usable price
New Hampshire NH8not enough hospitals filed a usable price
South Carolina SC8not enough hospitals filed a usable price
Wyoming WY8not enough hospitals filed a usable price
Hawaii HI7not enough hospitals filed a usable price
South Dakota SD7not enough hospitals filed a usable price
New Mexico NM5not enough hospitals filed a usable price
Vermont VT5not enough hospitals filed a usable price
Alaska AK4not enough hospitals filed a usable price
Alabama AL4not enough hospitals filed a usable price
Arkansas AR3not enough hospitals filed a usable price
Nevada NV3not enough hospitals filed a usable price
Rhode Island RI3not enough hospitals filed a usable price
Massachusetts MA2not enough hospitals filed a usable price
Connecticut CT1not enough hospitals filed a usable price
Maryland MD1not enough hospitals filed a usable price
Utah UT1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $88.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care531$88$49 – $138
Children’s12fewer than 20 hospitals
Critical access319$89$51 – $131
Ownership
For-profit67$72$35 – $146
Government197$90$54 – $126
Non-profit598$89$52 – $138
System affiliation
Part of a system656$87$47 – $138
Independent206$90$56 – $133

Cash price vs list price

Median list price (chargemaster)$131
Median cash price$88
Cash as a share of list, median hospital65%

At the typical hospital, asking for the cash price cuts the list price by about 35%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

495 hospitals filed a usable inpatient cash price for this code. The median is $90 and the average of the middle 60% is $93; most fall between $55 and $140.

Cash price percentiles, inpatient, across 495 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$39$63$90$132$235

The most expensive tenth of hospitals charges at least 6.0× what the cheapest tenth charges ($39 vs $235).

Of the 516 hospitals that filed this code inpatient, 495 gave a usable cash price; 5 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 16 a list price only.

How complete is this

862 of the 3,956 hospitals with a price file in our corpus (22%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 899 hospitals that filed this code at all gave us
Usable cash price — counted862
Cash price carrying a plausibility flag — shown on the compare tool, excluded here15
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded22
Hospitals that filed this code899

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 25, 2026; the figures were computed September 25, 2026 from filings loaded through September 25, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Consultation, evaluation, and preventative care family.

Hospitals file this code under descriptions such as Chronic Care Mgmt Svcs Staff 1st 20 Min Cal Mo.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Chronic care management by staff, 20 minutes a month (CPT 99490) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99490-chronic-care-management-by-staff-20-minutes-a-month