The CMS reimbursement for code 99490 for 2015 is $42.60, subject to change with sustainable growth rate formula modifications. The patient is responsible for a 20% copayment. Documented beneficiary consent in the record is expected, and the patient should understand the chronic care services available, that only one provider will bill for any calendar month, and that health information will be shared with other providers for care coordination. As chronic care management encompasses a broad range of services, codes that should not be reported in the same calendar month as 99490 include those for end-stage renal disease (90951-90970), education and training for self-management (98960-98962), non-face-to-face non-physician services (98966-98969), educational supplies (99071), group education (99078), insurance forms (99080), analysis of clinical data stored in computers (99090), analysis of physiologic data (99091), domiciliary or home care plan oversight (99339-99340), prolonged services without direct patient contact (99358-99359), case management services including anticoagulation management and medical team conferences (99363-99368), care plan oversight services (99374-99380), telephone or online evaluation (99441-99444), transitional care management (99495-99496), and medication therapy management (99605-99607). As the CMS has not recognized the complex chronic care management codes for separate payment, 99487 and 99489 are also “bundled” into 99490 for the purposes of Medicare. Furthermore, Healthcare Common Procedure Coding System codes G0181/G0182 (home health-care supervision/hospice care supervision) are also not to be reported with 99490 in the same calendar month. Face-to-face evaluation and management services that are provided during the same calendar month as chronic care coordination may be billed, but the time spent by the physician and/or clinical staff during the visit may not be included in the chronic care management service time. For documentation of the minimum 20-min time period spent for chronic care coordination, it is recommended that a log be maintained indicating the individual providing each service and his or her credentials, the date, services rendered, and cumulative or “start-stop” time. As an example, consider a patient with severe chronic obstructive lung disease, steroid-induced diabetes mellitus, atrial fibrillation, and fluid retention. Non-face-to-face services might include contact to assess clinical status and compliance, monitor a steroid taper, or adjust anticoagulation and diuretics, with subsequent follow-up of each problem and response to therapy. In this case, clinical documentation should include the specific services and interventions, along with the date and time spent for each encounter.