What Is The CCM Program?

What Health IT domains are necessary for a successful PCMH model?

Under the Centers for Medicare & Medicaid Services (CMS) CCM program, physician practices can charge $42.60 per month for 20 minutes of non face-to-face chronic care activity – this can increase your revenue by thousands! Let’s say for example, a practice bills a patient for 12 months. That’s $511.20 for one patient. Multiply that by 50 patients, and that’s $25,560 annually in additional revenue!

What Are The CCM Eligibility Requirements?

Physicians, Physician Assistants, Clinical Nurse Specialists, Nurse Practitioners and Certified Nurse Midwives can bill for CCM services. Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) are also eligible to bill CCM services. To count towards CCM payments, the services must be done outside of regular office visits and the patient must also have more than one chronic condition, expected to last 12 months or more.

It is important to note, only one practitioner per patient is eligible to receive CCM payments over a given calendar month.

  • CPT Code: 99490
  • CPT Code: 99489
  • CPT Code: 99487
  • HCPCS Code: G0506

Additional Resources

What Do I Need To Know About The MIPS Cost Performance Category?

What Is PCMH?

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Promoting Interoperability FAQs