Examples of chronic conditions include, but are not limited to, the following:

  • Alzheimer’s disease and related dementia
  • Arthritis (osteoarthritis and rheumatoid)
  • Asthma
  • Atrial fibrillation
  • Autism spectrum disorders
  • Cancer
  • Cardiovascular Disease
  • Chronic Obstructive Pulmonary Disease
  • Depression
  • Diabetes
  • Hypertension
  • Infectious diseases such as HIV/AIDS

In 2017, CMS allowed for Patient verbal enrollment to initiate CCM services.  For new patients or patients not seen within one year prior to the start of CCM, Medicare requires an annual wellness visit (AWV) and allows for CCM enrollment reimbursement during a face-to-face visit with the billing practitioner and is separately billed.

CCM services include structured recording of patient health information, maintaining a comprehensive electronic care plan, managing transitions of care and other care management services, and coordinating and sharing patient health information timely within and outside the practice.

Medicare typically reimburses $64.02 (national average for 99490) for non-RHC / FQHCs and $79.25 for RHC / FQHCs (G0511) per CCM claim.

Chronic Care
Management Benefits
Outsourcing Chronic
Care Management
Patient Care
Generate Greater
Practice Revenue
Patient Monitoring
Highly Qualified
Care Coordinators
What is Chronic
Care Management?
Who is Eligible for Chronic
Care Management?