Chronic care management (CCM) allows your practice to get paid for the care coordination work your team is already doing — coordinating with specialists, managing medication lists, updating care plans, and following up with high-risk patients. Medicare covers at least 20 minutes of this work per month, per patient.
Avanti RMG manages your CCM program end-to-end, from patient identification and enrollment through monthly care coordination and billing.
Chronic care management is a Medicare-covered service for patients with two or more chronic conditions. It covers at least 20 minutes per month of non-face-to-face care coordination — including medication management, care plan development, specialist coordination, and patient education. CCM is billed under CPT 99490 and related codes.
Medicare reimburses $62.69 per patient per month for the first 20 minutes of CCM (CPT 99490), and $47.44 for each additional 20 minutes (CPT 99439). A practice with 100 CCM-enrolled patients billing 99490 monthly generates approximately $75,000 per year — before stacking RPM codes for eligible patients.
Yes. A patient with multiple chronic conditions may qualify for both CCM (care coordination) and RPM (device monitoring). Both can be billed in the same month as long as the clinical time and activities are documented separately. Avanti RMG manages this distinction to ensure compliant billing and maximize your per-patient revenue.
Medicare CCM covers patients with two or more chronic conditions expected to last at least 12 months or until death. Common qualifying conditions include diabetes, hypertension, COPD, heart failure, arthritis, depression, chronic kidney disease, and many others.
CCM requires: a comprehensive care plan for each enrolled patient, at least 20 minutes of non-face-to-face care coordination per month, patient consent, 24/7 access to clinical staff for urgent needs, and structured documentation. Avanti RMG manages all of these requirements on your behalf.
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