Fill a large pot with salted water and bring it to a boil. Add the cheese tortellini, cooking them per the package instructions until they are al dente.
Meanwhile, in a large skillet over medium heat, melt the butter.
Add the minced garlic to the butter and cook for 1 minute until fragrant.
Slowly pour in the heavy cream, stirring constantly.
Lower the heat and slowly incorporate 1 3/4 cups of Parmesan cheese until it melts and the sauce becomes smooth. If the sauce is thin, add up to 1/4 cup more cheese.
Season the sauce with salt and pepper to taste.
Drain the cooked tortellini and add it to the Alfredo sauce. Toss gently to coat. Serve warm, garnished with fresh herbs if using.