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The Chronic Care Management (CCM) services program provides comprehensive care management for patients with multiple chronic medical conditions. These services are provided between routine office visit. CCM services allow the health care provider and the patient/ caregivers to work together in the management of the patient’s chronic medical conditions.

CCM Services are part of Medicare Part B benefits for Medicare patients with two or more chronic conditions who are at significant risk of death, acute exacerbation/decompensation, or functional decline. The beneficiary may need to pay a monthly fee for CCM services. The beneficiary’s Medicare Part B deductible and coinsurance apply. If the beneficiary has supplemental insurance, it may help cover this monthly cost.

Services include interactions with patients, usually by telephone, to review medical records and test results or provide self-management education and support. Services also include interactions with the patient’s other healthcare providers to exchange health information, as well as management of care transitions and coordination of home- and community-based services.