Chronic Care Management — Nevada

CCM for Nevada Practices

Chronic Care Management Billing Across Nevada

Avanti Revenue Management Group manages chronic care management programs for Nevada private practices — handling the billing workflow, documentation structure, and time-tracking infrastructure that most practices are missing. CCM is one of the most consistently under-billed Medicare programs in primary care: the patients qualify, the work is being done, and the revenue isn't being collected.

At 2026 Medicare rates, a patient with two or more chronic conditions generates $66.13–$116.57/month in CCM revenue. For a Nevada practice with 50 qualifying patients, that's $3,306–$5,828/month in revenue currently sitting uncollected.

What Qualifies

Which Nevada Patients Are CCM-Eligible

Two or more chronic conditions expected to last at least 12 months. Common qualifying combinations seen in Nevada practices:

  • Type 2 diabetes + hypertension
  • COPD + depression or anxiety
  • Chronic kidney disease + heart failure
  • Obesity + hypertension
  • Atrial fibrillation + heart failure
  • Any two qualifying chronic conditions on the CMS list
2026 CCM Revenue

What Nevada Practices Can Collect

  • CPT 99490 (first 20 min): $66.13/patient/month
  • CPT 99439 (add'l 20 min): $50.44/patient/month
  • CPT 99487 (complex CCM, 60 min): $144.29/patient/month

Stack CCM with RPM for eligible patients and total per-patient revenue reaches $211–$261/month.

Common Questions

CCM in Nevada — FAQ

What is chronic care management and which Nevada patients qualify?

Chronic care management (CCM) is a Medicare program that reimburses practices for non-face-to-face care coordination for patients with two or more chronic conditions expected to last at least 12 months. Common qualifying combinations include diabetes + hypertension, COPD + depression, and chronic kidney disease + heart failure. Most Nevada primary care panels have 30–50% of patients who qualify.

How much does Medicare pay for CCM in 2026?

At 2026 rates, CPT 99490 pays $66.13/month for the first 20 minutes of care coordination. CPT 99439 pays $50.44 for each additional 20 minutes. Complex CCM (CPT 99487) pays $144.29 for the first 60 minutes. Most practices target $66.13–$116.57/patient/month depending on care complexity.

Can CCM be billed alongside RPM?

Yes — and most practices should. If a patient is enrolled in RPM and has two or more chronic conditions, they likely qualify for CCM as well. Billing both correctly — with separate documentation for each service — generates $211–$261/patient/month at 2026 rates. Avanti RMG manages the documentation structure to ensure both are billed compliantly.

What does the 20-minute CCM requirement mean in practice?

Medicare requires at least 20 minutes of documented non-face-to-face care coordination per month per patient to bill CPT 99490. This includes activities like medication management, care plan updates, specialist coordination, and patient follow-up calls. Most practices are already spending this time — they just aren't logging it in a way that generates a claim.

Learn More

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