Story by James Eastman / June 17, 2025
Medicare’s Chronic Care Management (CCM) program supports structured, non–face‑to‑face care for patients with two or more chronic conditions. Since CCM’s introduction in 2015, Chronic Care Staffing (CCS) has helped practices improve health outcomes, enhance care coordination, and establish a sustainable revenue model for providers. This post outlines the key benefits of utilizing CCS for CCM, leveraging recent research and a unique approach.
Medicare CCM covers services that go beyond traditional office visits, including care coordination, comprehensive care planning, and access to a dedicated care team. Eligible patients are those that have Medicare or Medicare Advantage coverage, have been seen by their primary care provider in the last twelve months, and currently have two or more ongoing chronic conditions expected to last at least 12 months or until death.
CCS case studies indicate regular CCM participation reduces emergency department visits, improves HgA1C levels, and additional quality metrics impacting the patient’s overall health.
Providers report higher patient satisfaction and better adherence to treatment as CCM care managers keep patients engaged and informed. One physician noted that patient outreach helped identify concerns before they escalated to emergency situations.
The coinsurance for CCM services is typically low – around $8 monthly, which can be covered by secondary insurances. At the same time, CCM reduces the need for more expensive hospital or ED visits.
Medicare chronic care management benefits include reimbursements using CPT codes 99490 and 99439. Even at modest engagement levels, CCM can add meaningful revenue. CCS helps expedite the revenue process by implementing a CCM program with zero upfront costs and no software purchase necessary.
Providers describe CCM as a system for “putting eyes on patients” between visits. It enables care managers to coordinate referrals, reconcile medications, and direct patients to social services, especially effective for post-discharge follow-up hscrc.maryland.gov.
General supervision rules allow clinical staff such as LPNs and CMAs to deliver CCM services under physician oversight. This delegation frees physicians to focus on face-to-face visits while the care team handles planning and coordination between office visits.
CCM aligns with value-based care models like ACOs. Care coordination efforts have helped generate over $1 billion in Medicare savings through reduced hospital use axios.com. CCM supports that same shift by lowering emergency and inpatient engagement and contributing to cost efficiency.
Chronic Care Staffing provides full CCM program support, including:
With Chronic Care Staffing, your practice can implement CCM without adding administrative burden, achieve healthcare payer compliance, and enhance patient retention and satisfaction.
