What Conditions Qualify for Chronic Care Management?
Story by CCS Editor / March 21, 2025
Chronic Care Management (CCM) is a vital Medicare program designed to support patients in managing their chronic conditions more effectively. Through CCM, patients receive dedicated care coordination, ensuring they stay on top of their health goals, medications, and necessary appointments. However, many healthcare providers may not fully understand which conditions qualify a patient for CCM.
To help you determine whether your practice serves patients eligible for Chronic Care Management, we’ve outlined a comprehensive list of qualifying conditions and how CCM can significantly enhance patient care and outcomes.
Who Qualifies for Chronic Care Management?
Medicare requires patients to have at least two or more chronic conditions that are expected to last 12 months or longer and put them at risk of health deterioration or functional decline. The decision to enroll a patient in CCM ultimately depends on the provider’s clinical judgment.
Below is a breakdown of the common chronic conditions that typically qualify for CCM:
Cardiovascular & Blood Disorders
- Hypertension (High Blood Pressure)
- Coronary Artery Disease (CAD)
- Congestive Heart Failure (CHF)
- Atrial Fibrillation (AFib)
- Hyperlipidemia (High Cholesterol)
- Peripheral Vascular Disease (PVD)
- Sickle Cell Disease
- Ischemic Heart Disease
Chronic Respiratory Conditions
- Chronic Obstructive Pulmonary Disease (COPD)
- Asthma
- Emphysema
- Cystic Fibrosis
Metabolic & Endocrine Disorders
- Diabetes (Type 1 and Type 2)
- Hypothyroidism
- Obesity
- Metabolic Syndrome
Neurological & Mental Health Conditions
- Alzheimer’s Disease & Other Dementias
- Parkinson’s Disease
- Epilepsy & Seizure Disorders
- Stroke
- Traumatic Brain Injury (TBI)
- Bipolar Disorder
- Anxiety & Depressive Disorders
- Schizophrenia & Other Psychotic Disorders
- Post-Traumatic Stress Disorder (PTSD)
Musculoskeletal & Autoimmune Conditions
- Osteoporosis
- Rheumatoid Arthritis
- Osteoarthritis
- Multiple Sclerosis (MS)
- Fibromyalgia
- Chronic Pain Syndrome
- Spinal Cord Injuries
Gastrointestinal & Digestive Disorders
- Crohn’s Disease
- Ulcerative Colitis
- Irritable Bowel Syndrome (IBS)
- Liver Disease & Cirrhosis
Kidney & Urological Conditions
- Chronic Kidney Disease (CKD)
- Benign Prostatic Hyperplasia (BPH)
- Kidney Cysts
Eye & Vision Disorders
- Glaucoma
- Diabetic Retinopathy
- Age-Related Macular Degeneration (AMD)
- Cataracts
Hearing & ENT Conditions
- Tinnitus
- Vertigo
- Hearing Loss
- Meniere’s Disease
Substance Use Disorders
- Alcohol Use Disorder
- Opioid Use Disorder
- Nicotine Dependence
- Other Drug Use Disorders
Other Disabling & Chronic Conditions
- Human Immunodeficiency Virus (HIV) & Acquired Immunodeficiency Syndrome (AIDS)
- Viral Hepatitis
- Developmental & Intellectual Disabilities
- Blindness & Severe Visual Impairments
How Chronic Care Management Supports Patients
Once a patient qualifies for CCM, they gain access to essential care coordination services, including:
- Monthly check-ins from a care coordinator
- Medication management and prescription refills
- Help scheduling appointments and follow-ups
- Creation of a personalized care plan to track health goals and needs
- Assistance with community resources such as transportation, food, and housing support
These services are designed to reduce hospitalizations, improve medication adherence, and enhance overall patient quality of life. By integrating CCM into your practice, you can provide ongoing, proactive care that prevents complications and supports better health outcomes.
Why Choose Chronic Care Staffing for CCM Services?
At Chronic Care Staffing, we specialize in providing seamless CCM program implementation for healthcare practices. Our CCM program requires no software integration, zero upfront costs, and all documentation is charted in real-time directly in your EMR. Our team helps identify eligible patients, handles enrollment, and delivers high-quality care coordination—allowing your practice to focus on in-person patient care while ensuring your CCM patients receive continuous support.
If your practice is looking to enhance patient care and improve health outcomes through Chronic Care Management, reach out to us today. Let’s work together to provide the best care possible for patients managing chronic conditions.
Contact Chronic Care Staffing today to learn more about CCM and how we can help your practice.
Categories: CCM, Chronic Care Management News
Tags: CCM, CCM Services, Chronic Care Management, Chronic Care Staffing
