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Procedure price report · Consultation, evaluation, and preventative care

Chronic care management by a doctor, 30 minutes a month

CPT 99491the billing code this page is about

Covers a physician's or other qualified clinician's own time coordinating care for a patient with two or more long-term conditions; one unit is at least 30 minutes in a calendar month.

Hospitals typically charge $130 cash for this outpatient procedure — the median across 352 hospitals that filed a usable cash price; the average of the middle 60% is $135. Most fall between $86 and $201 (20th–80th percentile).

Hospitals
352
States
43
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 352 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
$52$90$130$179$254

The most expensive tenth of hospitals charges at least 4.9× what the cheapest tenth charges ($52 vs $254).

How the prices are spread

$45 – $55: 19 hospitals$45$55 – $66: 10 hospitals$66 – $80: 17 hospitals$66$80 – $97: 42 hospitals$97 – $118: 31 hospitals$97$118 – $143: 67 hospitals$143 – $174: 56 hospitals$143$174 – $211: 30 hospitals$211 – $255: 34 hospitals$211$255 – $310: 12 hospitals$255median $130price bands are equal on a log scale
Hospitals per price band (318 of 352 — the bands cover the 5th to 95th percentile)
FromToHospitals
$45$5519
$55$6610
$66$8017
$80$9742
$97$11831
$118$14367
$143$17456
$174$21130
$211$25534
$255$31012

By state

The median cash price in each state, against the national median of $130.

Alaska: 2 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 1 hospital filed a usable price — fewer than 10, so no figureMEVermont: 4 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: 4 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $155 across 15 hospitalsWA$155Idaho: 1 hospital filed a usable price — fewer than 10, so no figureIDMontana: 8 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 3 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $169 across 18 hospitalsMN$169Illinois: median $156 across 14 hospitalsIL$156Wisconsin: median $142 across 17 hospitalsWI$142Michigan: median $93 across 36 hospitalsMI$93New York: median $137 across 24 hospitalsNY$137Massachusetts: no hospital in the corpus filed a usable priceMAOregon: median $154 across 18 hospitalsOR$154Nevada: 2 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 5 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 1 hospital filed a usable price — fewer than 10, so no figureSDIowa: median $156 across 18 hospitalsIA$156Indiana: median $121 across 19 hospitalsIN$121Ohio: 8 hospitals filed a usable price — fewer than 10, so no figureOHPennsylvania: median $50 across 16 hospitalsPA$50New Jersey: 1 hospital filed a usable price — fewer than 10, so no figureNJConnecticut: 1 hospital filed a usable price — fewer than 10, so no figureCTRhode Island: no hospital in the corpus filed a usable priceRICalifornia: 7 hospitals filed a usable price — fewer than 10, so no figureCAUtah: no hospital in the corpus filed a usable priceUTColorado: 4 hospitals filed a usable price — fewer than 10, so no figureCONebraska: 9 hospitals filed a usable price — fewer than 10, so no figureNEMissouri: 4 hospitals filed a usable price — fewer than 10, so no figureMOKentucky: 1 hospital filed a usable price — fewer than 10, so no figureKYWest Virginia: median $78 across 17 hospitalsWV$78Virginia: no hospital in the corpus filed a usable priceVAMaryland: no hospital in the corpus filed a usable priceMDDelaware: no hospital in the corpus filed a usable priceDEArizona: 3 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 1 hospital filed a usable price — fewer than 10, so no figureNMKansas: 9 hospitals filed a usable price — fewer than 10, so no figureKSArkansas: 1 hospital filed a usable price — fewer than 10, so no figureARTennessee: 8 hospitals filed a usable price — fewer than 10, so no figureTNNorth Carolina: no hospital in the corpus filed a usable priceNCSouth Carolina: median $128 across 13 hospitalsSC$128Oklahoma: median $115 across 10 hospitalsOK$115Louisiana: 4 hospitals filed a usable price — fewer than 10, so no figureLAMississippi: 1 hospital filed a usable price — fewer than 10, so no figureMSAlabama: 3 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: 6 hospitals filed a usable price — fewer than 10, so no figureGAHawaii: 3 hospitals filed a usable price — fewer than 10, so no figureHITexas: 7 hospitals filed a usable price — fewer than 10, so no figureTXFlorida: 5 hospitals filed a usable price — fewer than 10, so no figureFL
Cash price by state, most expensive first. National median $130. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Minnesota MN18$169+30%$96 – $241
Iowa IA18$156+20%$140 – $156
Illinois IL14$156+20%$123 – $247
Washington WA15$155+19%$118 – $310
Oregon OR18$154+19%$145 – $179
Wisconsin WI17$142+9%$114 – $142
New York NY24$137+5%$22 – $223
South Carolina SC13$128−1%$128 – $128
Indiana IN19$121−7%$94 – $171
Oklahoma OK10$115−12%$115 – $115
Michigan MI36$93−29%$89 – $136
West Virginia WV17$78−40%$57 – $165
Pennsylvania PA16$50−61%$46 – $96
Kansas KS9not enough hospitals filed a usable price
Nebraska NE9not enough hospitals filed a usable price
Montana MT8not enough hospitals filed a usable price
Ohio OH8not enough hospitals filed a usable price
Tennessee TN8not enough hospitals filed a usable price
California CA7not enough hospitals filed a usable price
Texas TX7not enough hospitals filed a usable price
Georgia GA6not enough hospitals filed a usable price
Florida FL5not enough hospitals filed a usable price
Wyoming WY5not enough hospitals filed a usable price
Colorado CO4not enough hospitals filed a usable price
Louisiana LA4not enough hospitals filed a usable price
Missouri MO4not enough hospitals filed a usable price
New Hampshire NH4not enough hospitals filed a usable price
Vermont VT4not enough hospitals filed a usable price
Alabama AL3not enough hospitals filed a usable price
Arizona AZ3not enough hospitals filed a usable price
Hawaii HI3not enough hospitals filed a usable price
North Dakota ND3not enough hospitals filed a usable price
Alaska AK2not enough hospitals filed a usable price
Nevada NV2not enough hospitals filed a usable price
Arkansas AR1not enough hospitals filed a usable price
Connecticut CT1not enough hospitals filed a usable price
Idaho ID1not enough hospitals filed a usable price
Kentucky KY1not enough hospitals filed a usable price
Maine ME1not enough hospitals filed a usable price
Mississippi MS1not enough hospitals filed a usable price
New Jersey NJ1not enough hospitals filed a usable price
New Mexico NM1not enough hospitals filed a usable price
South Dakota SD1not 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 $130.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care221$128$85 – $194
Children’s5fewer than 20 hospitals
Critical access125$142$89 – $208
Ownership
For-profit15fewer than 20 hospitals
Government80$145$90 – $236
Non-profit256$128$85 – $179
System affiliation
Part of a system262$128$85 – $184
Independent90$151$94 – $223

Cash price vs list price

Median list price (chargemaster)$210
Median cash price$130
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

189 hospitals filed a usable inpatient cash price for this code. The median is $142 and the average of the middle 60% is $138; most fall between $96 and $191.

Cash price percentiles, inpatient, across 189 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
$74$106$142$167$254

The most expensive tenth of hospitals charges at least 3.5× what the cheapest tenth charges ($74 vs $254).

Of the 195 hospitals that filed this code inpatient, 189 gave a usable cash price; 0 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 6 a list price only.

How complete is this

352 of the 3,956 hospitals with a price file in our corpus (9%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 372 hospitals that filed this code at all gave us
Usable cash price — counted352
Cash price carrying a plausibility flag — shown on the compare tool, excluded here3
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 — excluded17
Hospitals that filed this code372

Sections not shown for this setting

  • Against Medicare: Medicare has no separately payable national outpatient (OPPS) rate for this code, so there is nothing honest to compare against.
  • 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 Svc Phys 1st 30 Min Cal Month.

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 a doctor, 30 minutes a month (CPT 99491) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-99491-chronic-care-management-by-a-doctor-30-minutes-a-month