Original Medicare (Parts A & B): Chronic Care Management Services
If someone has 2 or more serious chronic conditions, Medicare may pay for a provider to help manage those conditions.
How To Receive
Details on how to apply
A healthcare provider must accept assignment for CCM.
Note that only one practitioner can provide CCM services during a calendar month.
The member must give the provider consent for CCM services.
Schedule an initiating visit.
Attend the visit and commence with CCM.
Note that CCM services are not typically face-to-face (in-person visits), though CCM efforts will also be discussed and implemented at all office visits.
For more information on Medicare benefits and coverage, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare Benefits Website. TTY users, call 1-877-486-2048.
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The Centers for Medicare and Medicaid Services (CMS) recognizes Chronic Care Management (CCM) as a critical primary care service that contributes to better health and care.
You or your loved one are eligible for CCM if they have 2 or more serious chronic conditions that are expected to last at least a year or until death, and/or that place them at significant risk of death, acute exacerbation, decompensation, or functional decline. Examples of chronic conditions include but aren't limited to:
Alzheimer’s disease and related dementia
Arthritis (osteoarthritis and rheumatoid)
Asthma
Atrial fibrillation
Autism spectrum disorders
Cancer
Cardiovascular disease
Chronic Obstructive Pulmonary Disease (COPD)
Depression
Diabetes
Hypertension
Infectious diseases like HIV and AIDS
CCM includes a comprehensive care plan that lists you or your loved one's health problems and goals, other providers, medications, community services they have and need, and other health information. It also explains the care you or your loved one need and how it will be coordinated. CCM and planning include:
An assessment of you or your loved one's medical, functional, and psychosocial needs
Receipt of timely recommended preventive services
A review of all medications and any potential interactions
Oversight of you or your loved one's medication self-management
Coordination of care with home- and community-based clinical service providers
Management of care transitions from one provider to another or one care setting to another
If you or your loved one agree to get this service, their provider will prepare the care plan for them or you (their caregiver), help you both with medication management, provide 24/7 access for urgent care management needs, give support when you or your loved one goes from one healthcare setting to another, review their medications and how they're taken, and help with other chronic care needs.
CMS equips providers with comprehensive materials and tools to function in the chronic condition management support role, so they are well-versed in how to help you or your loved one.
This service is provided for a monthly fee.
