Chronic Care Management
Active issue monitoring and comprehensive care coordination. Manage multiple chronic conditions effectively.
What is Chronic Care Management?
Chronic Care Management (CCM) provides non-face-to-face care coordination for patients with multiple chronic conditions. This program helps manage complex patients through comprehensive care planning and ongoing coordination.
Key Features
- Comprehensive care plan creation and annual review
- Quarterly medication reconciliation tracking
- Clinical staff time tracking (20/30/60 minutes based on complexity)
- Complex CCM support with detailed documentation
- 24/7 documented care team access
- CPT Codes: 99490, 99491, 99487, 99489
Who Can Benefit?
CCM is designed for patients who:
- •Have two or more chronic conditions
- •Need comprehensive care coordination
- •Require medication management support
- •Would benefit from 24/7 care team access
How It Works
CCM begins with creating a comprehensive care plan that addresses all of the patient's chronic conditions. The care team then provides ongoing coordination, medication reconciliation, and 24/7 access for patients. Care plans are reviewed and updated annually.
Medicare covers CCM services when patients have 2+ chronic conditions and meet the time requirements (20 minutes for standard CCM, 30-60 minutes for complex CCM).