Chronic care management services (2024)

If you have 2 or more serious chronic conditions (like arthritis and diabetes) that you expect to last at least a year, Medicare may pay for a health care provider’s help to manage your care for those conditions.

Your costs in Original Medicare

You pay a monthly fee, and the Part B deductibleand coinsurance apply. If you have supplemental insurance or another type of coverage, including Medicaid, it may help cover the monthly fee.

What it is

Chronic care management includes a comprehensive care plan that lists your health problems and goals, otherproviders, medications, community services you have and need, and other information about your health. It also explains the care you need and how your providers will coordinate it. Your health care provider will ask you to sign an agreement for you to get this set of services on a monthly basis.

If you agree to get this service, your providerwill prepare the care plan for you or your caregiver, help you with medication management, provide 24/7 access for urgent care needs, give you support when you go from one health care setting to another, review your medicines and how you take them, and help you with other chronic care needs.

Things to know

To get started, ask your health care providers if they offer chronic care management services.

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Chronic care management services (2024)

FAQs

What is a chronic care management service? ›

What it is. Chronic care management includes a comprehensive care plan that lists your health problems and goals, other providers, medications, community services you have and need, and other information about your health. It also explains the care you need and how your providers will coordinate it.

What conditions are eligible for CCM? ›

Those that can potentially qualify for CCM include: Alcohol dependence disorders. Opioid dependence disorders. Nicotine dependence.

What does a CCM do? ›

The goal of CCM services is to provide coverage for the many non-face-to-face interactions that are needed to optimally manage multiple chronic conditions.

What does chronic disease management include? ›

If you have a chronic condition, you can manage it by: making regular visits to your general practitioner or specialist. having a healthy lifestyle, including eating well, exercising and getting enough sleep. taking your prescribed medicines.

Is CCM only for Medicare patients? ›

CCM, or chronic care management, is a collection of resources available to Medicare beneficiaries with two or more chronic conditions.

Is chronic care management worth it? ›

By providing personalized care plans, regular monitoring, and ongoing support, CCM enhances patient satisfaction. Patients feel more involved in their healthcare decisions, have better access to their healthcare team, and experience a higher level of care coordination.

What does it mean if someone has CCM? ›

A cerebral cavernous malformation (CCM) is a collection of small blood vessels (capillaries) in the central nervous system that is enlarged and irregular in structure. In CCM, the walls of the capillaries are thinner than normal, less elastic, and are likely to leak.

How does CCM work? ›

CCM therapy uses a device that delivers precisely timed electrical pulses to your heart. These pulses are intended to help your heart's ability to contract and pump blood.

What are the duties and responsibilities of CCM? ›

Position Summary: The CCM Specialist works with Primary Care Providers (PCP), care center staff, and Nurse Care Managers to provide telephonic management of patients with multiple chronic conditions and increased risk factors to ensure excellent care is provided outside of office visits.

What are 4 major chronic diseases? ›

The most common are cancers, cardiovascular diseases, chronic respiratory diseases and diabetes. Unhealthy eating, physical inactivity, harmful use of alcohol and tobacco use are major contributors to the burden of chronic diseases.

How do you qualify for a chronic disease management plan? ›

If you have a chronic (or terminal) medical condition, your GP may suggest a GPMP. If you also have complex care needs and require treatment from two or more other health care providers, your GP may suggest TCAs as well. Your GP or practice staff must obtain your agreement before providing these plans.

What are the 5 C's of chronic disease? ›

In optimising the consultation, five C's need attention: control, compliance, complications, counseling/concerns, and customization. Patients with chronic conditions must become the principal caregiver themselves looking after their diet, exercise, lifestyle modification, medication use, and self monitoring.

What is the meaning of chronic management? ›

An integrated care approach to managing illness which includes screenings, check-ups, monitoring and coordinating treatment, and patient education.

How do you explain CCM to patients? ›

What Is Chronic Care Management, or “CCM?” If you have Medicare or both Medicare and Medicaid, and have two or more chronic conditions, Medicare is offering CCM services to help you manage your health and spend more time doing the things you enjoy, in good health.

How often can chronic care management be billed? ›

This also includes billing multiple increments of 20 minutes of CCM services, similar to how code 99439 is used as an add-on to code 99490 for an additional 20 minutes of care provided. However, while the code's definition expands to cover multiple instances, this bill can only be submitted once per calendar month.

What is an example of chronic care? ›

Some of the most common diseases in chronic care management include Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), Diabetes, and Hypertension (High Blood Pressure).

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