Chronic Care Management Program through Medicare

If you are a Medicare patient of if Medicare is your supplement, you may benefit from this plan!


In Medicare's own words:

Medicare began paying for CCM services separately under the Physician Fee Schedule (PFS) in 2015 for Medicare patients. This allows eligible practitioners to bill for at least 20 minutes of non-face-to-face clinical staff time directed by a physician or other qualified health care professional per calendar month for Medicare patients with multiple chronic conditions.


Chronic care management is care coordination services done outside of the regular office visit for patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.

This program allows our practice to be paid by Medicare on a monthly basis for all the non-office visit work done on our patients with chronic issues behalf.  This includes monthly reminders about preventative care, forms completed and even Prior Authorizations for medications not initially covered by insurance.  These are things done by the office on a regular basis that were never billed by us previously but occupied many man hours by our staff.  We were very excited when the program came out!

It has also, we've found out, allowed us to be more aware of our patients with these chronic issues allowing for better care and communication.  Reaching out monthly, managing conditions and offering a chronic care coordinator who is available to answer questions or direct patients to medical services even on the weekends has increased our connection with our most vulnerable patients and resulted in better care and health.

We hope to participate with our patients in the Chronic Care Management program for many years to come!


For more information:

Medicare Chronic Care Management- Outreach and Education

Medicare Chronic Care Management Patient Information