Chronic Care Management CPT Codes and Medicare Reimbursement in 2026: Complete CCM Billing Guide

Updated for 2026. Chronic Care Management (CCM) is an important Medicare service that supports ongoing care coordination for eligible patients living with multiple chronic conditions. For independent medical practices, understanding CCM billing codes and reimbursement requirements is essential to operating an effective and financially sustainable care management program.

Medicare recognizes several Current Procedural Terminology (CPT) codes for standard and complex Chronic Care Management services. Each code has specific requirements involving qualifying time, clinical staff responsibilities, practitioner involvement and documentation.

Incorrect code selection, incomplete patient consent, inaccurate time tracking or duplicate billing can lead to denied claims and compliance concerns.

This comprehensive guide explains the main CCM CPT codes for 2026, Medicare reimbursement considerations, billing requirements, documentation standards and practical strategies for healthcare practices.

What Is Chronic Care Management Billing?

Chronic Care Management billing allows eligible healthcare practitioners to report qualifying ongoing care management services provided to Medicare beneficiaries with multiple chronic conditions.

CCM services are primarily non-face-to-face and typically occur throughout a calendar month.

Examples of qualifying clinical activities may include medication management, comprehensive care planning, patient communication, specialist coordination and clinically appropriate follow-up.

Whether an activity qualifies for billing depends on the applicable code requirements and the services actually furnished.

Who Is Eligible for Medicare CCM?

Traditional Medicare CCM generally applies to patients who meet the following criteria:

• Two or more qualifying chronic conditions
• Conditions expected to last at least 12 months or until death
• Significant risk of death, acute exacerbation or decompensation, or functional decline
• Required CCM services furnished and documented
• Appropriate patient consent obtained before billing

Examples of conditions that may be relevant to CCM include diabetes, hypertension, chronic kidney disease, chronic obstructive pulmonary disease, heart failure and certain other long-term conditions.

However, having two diagnoses does not automatically establish eligibility. The practitioner must evaluate the complete clinical requirements.

Complete List of CCM CPT Codes for 2026

Medicare recognizes standard CCM, practitioner-performed CCM and complex CCM billing pathways.

Code selection must account for all applicable requirements, not merely the amount of recorded time.

2026 Medicare CCM Reimbursement Rates

Medicare payment amounts vary according to the CPT code, geographic payment locality, place of service, practitioner circumstances and applicable payment adjustments.

The following reference amounts illustrate national non-facility payments reported in the Medicare Payment Advisory Commission's March 2026 report.

Payment note: These figures are published national non-facility reference amounts, not guaranteed reimbursement for any practice. Actual approved amounts may differ by locality, facility status, qualifying Alternative Payment Model participation and other Medicare payment factors. Verify the applicable date-of-service rate through the CMS Physician Fee Schedule Look-Up Tool or the relevant Medicare Administrative Contractor.

What Changed in Medicare Physician Payments for 2026?

CMS finalized two separate Physician Fee Schedule conversion factors for calendar year 2026.

• $33.57: Conversion factor for qualifying Alternative Payment Model participants.
• $33.40: Conversion factor for practitioners who are not qualifying APM participants.

These values include statutory payment updates and finalized payment adjustments.

Conversion factors are used with relative value units and geographic adjustments to determine applicable payment amounts. They are not themselves the reimbursement paid for an individual CCM service.

CMS also finalized policies affecting care management reporting for Rural Health Clinics and Federally Qualified Health Centers. These organizations should review the specific 2026 rules applicable to their settings.

CPT 99490: Standard Chronic Care Management

CPT 99490 is a commonly used code for standard clinical-staff Chronic Care Management.

It generally represents the first 20 minutes of qualifying care management services furnished during a calendar month under the direction of a physician or other qualified healthcare professional.

Important Requirements

• The patient meets traditional CCM eligibility requirements.
• Required patient consent is obtained and documented.
• A comprehensive patient-centered care plan is maintained.
• Qualifying clinical staff services are furnished.
• At least 20 minutes of qualifying time are completed.
• All other applicable CCM service requirements are satisfied.

99490 Billing Example

A qualifying patient receives 20 minutes of documented clinical-staff care management during October.

The activities include a clinically appropriate medication review and coordination with another healthcare professional.

If all other code requirements are satisfied, the billing practitioner may evaluate CPT 99490 for that calendar month.

The example assumes the services qualify under Medicare rules and are not counted toward another billed service.

CPT 99439: Additional Standard CCM Time

CPT 99439 is an add-on code used with CPT 99490 when additional qualifying clinical-staff CCM time is furnished.

It represents each additional 20-minute increment under applicable Medicare coding rules.

99439 Example

A patient receives 40 minutes of qualifying standard clinical-staff CCM during a calendar month.

The practice may evaluate:

• 99490 for the first 20 minutes
• 99439 for the additional 20 minutes

Additional units must comply with applicable code instructions, Medicare unit limits and claim-edit policies.

Practices should never add time artificially to reach another billing increment.

CPT 99491: CCM Personally Performed by a Practitioner

CPT 99491 describes CCM services personally performed by a physician or other qualified healthcare professional.

The base service generally requires at least 30 minutes of qualifying practitioner time during the calendar month.

Unlike the clinical-staff pathway, clinical staff time does not count toward the time threshold for CPT 99491.

Example

A qualified practitioner personally spends 30 minutes during the calendar month reviewing chronic disease management needs, coordinating care and performing other qualifying CCM activities.

If all applicable requirements are satisfied, the practitioner may evaluate CPT 99491.

Practitioner time must be documented appropriately and must not be double counted toward another reported service.

CPT 99437: Additional Practitioner CCM

CPT 99437 is an add-on code associated with CPT 99491.

It describes each additional 30 minutes of qualifying CCM personally performed by the physician or other qualified healthcare professional.

Example

A practitioner personally performs 60 minutes of qualifying CCM services during a calendar month.

Subject to all applicable requirements, the relevant codes may include 99491 for the initial 30 minutes and 99437 for the additional 30 minutes.

Clinical-staff time cannot be substituted for the practitioner's personal time requirement.

CPT 99487: Complex Chronic Care Management

CPT 99487 describes complex CCM services involving more demanding clinical management requirements.

The base service generally requires at least 60 minutes of qualifying clinical-staff time during the calendar month.

Complex CCM also requires moderate- to high-complexity medical decision-making by the billing practitioner and establishment or substantial revision of a comprehensive care plan.

Important Complex CCM Requirements

• Qualifying chronic condition eligibility
• Required consent and CCM service elements
• At least 60 minutes of qualifying clinical-staff time
• Moderate- to high-complexity medical decision-making by the practitioner
• Establishment or substantial revision of the comprehensive care plan
• Appropriate supporting documentation

Example

A patient with heart failure, chronic kidney disease and diabetes experiences significant changes in clinical management needs.

The practitioner performs moderate- or high-complexity medical decision-making and substantially revises the comprehensive care plan.

Qualifying clinical staff provide at least 60 minutes of documented care management activities during the calendar month.

When every applicable requirement is satisfied, CPT 99487 may be appropriate.

The number of diagnoses or the length of time alone does not automatically make care management complex.

CPT 99489: Additional Complex CCM Time

CPT 99489 is an add-on code for additional qualifying clinical-staff time associated with complex CCM.

It generally represents each additional 30 minutes beyond the initial complex CCM service.

Example

A patient receives 90 minutes of qualifying complex CCM clinical-staff services during the calendar month.

If complex CCM requirements are satisfied, the practice may evaluate CPT 99487 for the initial 60 minutes and CPT 99489 for the additional 30 minutes.

Additional units require proper documentation and compliance with applicable Medicare code instructions and claim limits.

Standard CCM vs Complex CCM

Standard and complex CCM should not be reported together for the same patient during the same calendar month.

HCPCS G0506: Extensive Assessment and Care Planning

HCPCS G0506 may apply when the billing practitioner personally performs extensive assessment and care planning beyond the usual work associated with an appropriate CCM initiating visit.

CMS explains that G0506 may be billed once in association with the qualifying initiating visit when applicable requirements are satisfied.

This is not a recurring monthly CCM add-on code.

The practice should verify the current code requirements and payment rules before submitting G0506.

Medicare CCM Patient Consent Requirements

Patient consent is required before billing for CCM services.

CMS permits written or verbal consent when appropriately obtained and documented.

Information Patients Must Understand

• CCM services are available.
• Applicable cost sharing may apply.
• Only one practitioner can furnish and bill CCM services during a calendar month.
• Patients can discontinue the service at any time, effective at the end of the calendar month.

Practices should document the patient's consent decision and any required information provided during enrollment.

Required CCM consent should not be confused with a separate HIPAA authorization. These are different legal and program requirements.

Does Medicare Pay 100% for CCM?

Not necessarily.

Medicare Part B may cover eligible Chronic Care Management services, but patient cost sharing can apply.

Under Original Medicare, after the Part B deductible is met, beneficiaries generally pay 20% of the Medicare-approved amount for covered CCM services.

Supplemental insurance, Medicaid eligibility and other coverage arrangements may affect the patient's actual responsibility.

Practices should explain these potential costs before obtaining CCM consent.

How to Calculate CCM Patient Cost Sharing

Consider a hypothetical CCM service with a Medicare-approved amount of $60.

If the Part B deductible has been satisfied and the standard 20% coinsurance applies, the illustrative calculation is:

Patient coinsurance: $60 × 20% = $12.

Medicare share: $60 × 80% = $48.

This is a simplified example. Actual patient responsibility depends on coverage, deductibles, assignment and other applicable Medicare rules.

How to Estimate Monthly CCM Revenue

Medical practices can estimate potential gross allowed reimbursement by reviewing qualifying patient-months and applicable payment amounts.

Basic Formula

Qualifying billable patient-months × applicable allowed amount = estimated gross allowed reimbursement.

Example: 50 CCM Patient-Months

Assume a practice has 50 qualifying patient-months billed using CPT 99490.

Using the published 2026 national non-facility reference amount of $66.13:

50 × $66.13 = $3,306.50.

This represents illustrative gross allowed reimbursement, not the amount necessarily paid directly by Medicare or collected by the practice.

Example: 100 CCM Patient-Months

Using the same reference:

100 × $66.13 = $6,613.

Example: 200 CCM Patient-Months

200 × $66.13 = $13,226.

These examples assume every patient-month qualifies for billing and use an illustrative national reference rate. Actual payment varies, and no particular patient-month is guaranteed to qualify.

Estimated CCM Revenue by Patient Volume

Financial disclaimer: This table is a mathematical illustration based on one national reference amount. It is not a revenue forecast, payer contract quotation or guarantee of collection.

Program profitability also depends on clinical staffing, benefits, software licensing, supervision, patient engagement, claim denials, patient cost sharing and administrative expenses.

How to Calculate CCM Program Profitability

Practices should assess both revenue and the cost of providing appropriate care management.

Example Expense Categories

• Qualified clinical staff compensation
• Practitioner oversight time
• Employee benefits and related staffing expenses
• CCM software subscriptions
• Training and onboarding
• Patient communication costs
• Clinical documentation administration
• Billing and revenue cycle management
• Security and HIPAA compliance expenses
• Operational support

A basic financial model is:

Collected CCM revenue − total CCM operating costs = estimated program operating contribution.

Practices should distinguish gross allowed reimbursement, actual payments and net financial performance.

CCM Time Tracking Requirements

Accurate documentation of qualifying time is central to traditional CCM billing.

Time should reflect qualifying care management services actually furnished to the patient.

Recommended Time Documentation

• Patient identifier
• Date of activity
• Staff member or practitioner responsible
• Description of the service performed
• Clinical purpose of the activity
• Documented duration
• Applicable code category
• Monthly qualifying time total
• Relevant practitioner review

Practices should establish clear rules distinguishing qualifying clinical activity from nonqualifying administrative work.

Clinical-staff and practitioner-performed billing pathways have different time attribution requirements.

For example, practitioner-personally-performed CCM codes cannot count clinical-staff time toward the practitioner's personal time threshold.

Which CCM Activities May Count Toward Billing Time?

Appropriate activities may include clinical care coordination, medication management, patient communication, care plan review and other services meeting the requirements of the applicable CCM code.

Examples to Evaluate

• Reviewing relevant changes in patient health status
• Coordinating prescribed treatment with another practitioner
• Supporting medication reconciliation
• Updating a comprehensive care plan
• Discussing clinically relevant concerns with the patient
• Coordinating appropriate community or caregiver support
• Following up on medically relevant referrals

Whether any particular activity can be counted depends on the service circumstances, staff qualifications and current coding requirements.

Which Activities Should Not Automatically Count?

Not every task associated with a CCM program qualifies as billable care management time.

Examples requiring careful exclusion or evaluation include:

• Purely administrative scheduling
• General software maintenance
• Unrelated billing and payment processing
• Staff training unrelated to an individual qualifying service
• Unsuccessful outreach without qualifying care management work
• Work already counted toward another billed service
• Time performed by staff who do not meet applicable qualifications

Organizations should review CMS rules, CPT instructions and applicable payer guidance when determining qualifying activity.

Clinical Staff Supervision Requirements

Qualifying clinical staff may provide certain CCM services under general supervision, subject to Medicare's applicable rules.

General supervision does not require the supervising practitioner to be physically present throughout every qualifying service.

However, the billing practitioner retains responsibility for the service and must comply with applicable supervision and direction requirements.

State law, licensure, professional qualifications and scope-of-practice rules must also be considered.

Who Can Bill CCM?

CMS identifies eligible billing practitioners, including physicians and certain qualified nonphysician practitioners, when applicable requirements are met.

Examples include:

• Physicians
• Nurse practitioners
• Physician assistants
• Clinical nurse specialists
• Certified nurse-midwives

Specific practitioner eligibility and billing rules should be verified under current Medicare regulations.

Clinical staff may support qualifying CCM services under appropriate supervision, but that does not mean every participating employee can independently bill Medicare.

Can Two Providers Bill CCM for the Same Patient?

Medicare generally allows only one practitioner to furnish and bill CCM services for the same beneficiary during a calendar month.

Practices should establish procedures to identify possible overlapping care management arrangements.

Patients should receive the required explanation regarding this limitation during the consent process.

When patients change practitioners, appropriate coordination helps prevent duplicate billing and confusion about care management responsibilities.

Can CCM and RPM Be Billed Together?

Chronic Care Management and Remote Patient Monitoring address different clinical needs.

CCM focuses on ongoing management and coordination of multiple chronic conditions.

RPM focuses on qualifying remote physiologic monitoring and associated services.

Concurrent billing may be appropriate when each service independently meets applicable requirements and Medicare permits the combination.

The same time and effort must not be counted twice when duplicate reporting is prohibited.

Can CCM and TCM Be Billed Together?

Transitional Care Management supports eligible patients during a 30-day period following discharge from a qualifying healthcare setting.

CMS permits certain CCM services to be reported during a TCM service period under applicable rules.

However, practices must distinguish the services furnished and comply with current documentation, time and concurrent billing requirements.

A hospital discharge alone does not establish eligibility for TCM or CCM reimbursement.

CCM vs APCM Billing in 2026

Advanced Primary Care Management (APCM) provides a broader monthly primary care model than traditional CCM.

APCM includes specified advanced primary care requirements and does not use the same monthly minute thresholds as traditional CCM.

Its foundational codes include G0556, G0557 and G0558, depending on applicable patient and coverage criteria.

Practices should not assume that traditional CCM codes can be separately billed in addition to an APCM monthly service.

Current CMS bundling and reporting requirements must be reviewed when selecting the appropriate care management model.

Special Billing Considerations for RHCs and FQHCs

Rural Health Clinics and Federally Qualified Health Centers have special Medicare billing and payment rules.

For 2026, CMS finalized changes affecting separate payment and individual code reporting for qualifying care coordination services in these settings.

RHCs and FQHCs should review the current CMS instructions applicable to their service categories and not automatically apply ordinary physician-office payment assumptions.

Common CCM Claim Denial Reasons

CCM claims may be rejected or denied for several reasons, depending on payer edits and the underlying documentation.

Insufficient Qualifying Time

The medical record does not support the applicable minimum service time.

Missing Patient Consent

Required CCM consent was not obtained or documented before billing.

Incorrect Code Selection

The billed code does not match the service performed or required clinical complexity.

Duplicate Monthly CCM Billing

Another practitioner may have submitted an incompatible CCM claim for the same patient-month.

Improper Add-On Reporting

An add-on code may be reported without the required base code or supporting additional service time.

Incompatible Concurrent Services

The claim includes service combinations that do not satisfy Medicare reporting rules.

Incomplete Care Plan Documentation

Applicable comprehensive care planning requirements were not satisfied.

Practitioner or Staff Eligibility Problems

The billed service may not meet professional qualification or supervision requirements.

Practices should review specific denial and remittance information rather than assuming every rejection has the same cause.

Monthly CCM Billing Checklist

• Confirm the patient's qualifying chronic conditions.
• Verify applicable clinical risk criteria.
• Confirm appropriate patient consent.
• Verify initiating visit requirements.
• Maintain the comprehensive care plan.
• Confirm the billing practitioner.
• Verify staff qualifications and supervision.
• Review documented care management activities.
• Calculate qualifying time accurately.
• Exclude duplicate or nonqualifying time.
• Determine whether standard or complex CCM applies.
• Verify practitioner-performed versus clinical-staff coding.
• Apply add-on codes only when supported.
• Review concurrent billing restrictions.
• Confirm applicable Medicare payment and reporting rules.
• Verify claim details and dates of service.
• Maintain appropriate supporting documentation.

How CCM Software Can Help with Billing Documentation

Dedicated CCM software may help healthcare practices organize the information needed for care management documentation and monthly billing review.

Features to Evaluate

• Patient eligibility documentation
• Consent record management
• Care plan documentation
• Provider and care coordinator assignments
• Care management activity records
• Staff attribution and qualifying time tracking
• Monthly activity summaries
• Potential duplicate billing checks
• Code-specific billing review workflows
• Audit history
• Practice-level reporting

Actual capabilities vary between software products.

Software should support accurate review rather than automatically assuming that recorded activity is billable.

Using HL7 FHIR with CCM Billing Workflows

HL7 FHIR provides standardized resources and APIs for exchanging clinical information between compatible healthcare systems.

For a CCM platform, supported FHIR integrations may provide relevant patient demographics, diagnoses, medication information, clinical observations and care planning context.

However, imported FHIR resources do not automatically establish CCM eligibility or qualifying billable time.

A diagnosis imported from an EHR must be reviewed in the context of the patient's clinical condition.

Similarly, importing a medication list or care plan is not equivalent to performing and documenting a qualifying CCM activity.

Healthcare practices should maintain appropriate separation between clinical data exchange and billable care management services.

HIPAA Compliance and CCM Billing Records

CCM documentation may contain protected health information and must be handled according to applicable HIPAA requirements.

Healthcare organizations should evaluate:

• Appropriate user permissions
• Access to patient records
• Audit controls
• Secure authentication
• Transmission security
• Protected storage and backups
• Vendor agreements
• Security incident response
• Retention and documentation policies

A hosted CCM software vendor handling PHI on behalf of a HIPAA-covered healthcare organization generally qualifies as a business associate and must enter into an appropriate Business Associate Agreement.

Signing a BAA does not independently establish HIPAA compliance. Appropriate safeguards and operational procedures must also be implemented.

How to Check Your Actual 2026 Medicare CCM Payment Rate

Because Medicare payment rates vary, healthcare practices should verify the actual applicable fee schedule before estimating collections.

1. Visit the official CMS Physician Fee Schedule Look-Up Tool.
2. Select the applicable calendar year and procedure code.
3. Identify the relevant Medicare payment locality.
4. Review the facility or non-facility setting as appropriate.
5. Account for qualifying APM participation and other applicable adjustments.
6. Confirm the rate against relevant CMS payment files or Medicare Administrative Contractor guidance.

Official CMS fee schedule files provide the authoritative basis for evaluating applicable Original Medicare payment rates.

Commercial insurance and Medicare Advantage arrangements may use different reimbursement methodologies and requirements.

Best Practices for Accurate CCM Reimbursement

• Begin with clinically appropriate services.
• Confirm eligibility before enrollment.
• Explain cost sharing transparently.
• Document patient consent.
• Maintain comprehensive care plans.
• Train clinical and administrative staff.
• Record qualifying care management activities accurately.
• Use the correct CPT code pathway.
• Separate practitioner and clinical-staff time appropriately.
• Review complex CCM requirements carefully.
• Prevent duplicate service reporting.
• Review current CMS and MAC guidance.
• Monitor claim denials and documentation problems.
• Evaluate actual collections and program expenses.

How ChronicSync Fits into CCM Program Management

Accurate Chronic Care Management billing depends on well-organized clinical operations and reliable documentation.

ChronicSync focuses on helping healthcare practices organize chronic care workflows, patient information, provider assignments and care coordination activities.

For practices evaluating CCM software, important considerations include patient enrollment, care planning, activity documentation, care team responsibilities, reporting and the ability to support appropriate billing review processes.

Healthcare organizations considering ChronicSync should verify currently available product functionality, security documentation, hosting arrangements and Business Associate Agreement availability before processing live patient information.

Explore the ChronicSync Demo to learn more about digital care management workflows.

Frequently Asked Questions

What are the main CCM CPT codes in 2026?

The main traditional CCM codes include 99490, 99439, 99491, 99437, 99487 and 99489. Each has different time and service requirements.

How much does Medicare pay for CPT 99490 in 2026?

The March 2026 MedPAC report lists a national non-facility reference amount of $66.13. Actual Medicare payment varies according to locality, setting and other applicable factors.

What is the difference between CPT 99490 and 99439?

99490 describes the initial 20 minutes of qualifying standard clinical-staff CCM, while 99439 is an add-on code for additional qualifying 20-minute increments.

What is the difference between 99490 and 99491?

99490 is associated with qualifying clinical-staff CCM under practitioner direction. 99491 describes at least 30 minutes of CCM personally performed by the physician or other qualified healthcare professional.

What is CPT 99487?

99487 is the complex CCM base code associated with at least 60 minutes of qualifying clinical-staff time, moderate- to high-complexity practitioner medical decision-making and establishment or substantial revision of a comprehensive care plan.

Can CPT 99490 and 99487 be billed together?

No. Standard and complex CCM cannot both be reported for the same patient during the same calendar month.

What is the minimum time required for CCM billing?

The threshold depends on the code. For example, 99490 generally requires 20 minutes, 99491 requires 30 minutes of personally performed practitioner services and 99487 requires 60 minutes plus other complex CCM requirements.

Can a practitioner count clinical staff time toward CPT 99491?

No. The 99491 time threshold is based on services personally performed by the billing practitioner.

Is CCM reimbursement available every month?

CCM can be reported for qualifying calendar months when all applicable patient, service, documentation and billing requirements are satisfied.

Can two practitioners bill CCM for the same patient in one month?

Medicare generally permits only one practitioner to furnish and bill CCM for the same beneficiary during a calendar month.

Does Medicare require patient consent for CCM?

Yes. Required written or verbal consent must be obtained and documented before billing CCM.

Does the patient pay for CCM?

Cost sharing may apply. Under Original Medicare, the standard Part B coinsurance is generally 20% of the Medicare-approved amount after the deductible, subject to other coverage and applicable circumstances.

Can CCM and RPM be billed together?

Potentially, when each service independently meets applicable requirements and current concurrent billing rules are satisfied. Duplicate time or services must not be reported improperly.

Can CCM and TCM be billed together?

Certain CCM services may be reportable during a TCM period under CMS rules. Practices must satisfy all relevant requirements and avoid prohibited duplicate reporting.

Is APCM the same as CCM?

No. APCM is a different Medicare monthly advanced primary care model with distinct operational and billing requirements.

Can CCM software automatically determine reimbursement?

Software may support coding and documentation workflows, but actual reimbursement depends on applicable Medicare rules, service delivery, claim processing and payer policies.

Do all states have the same CCM reimbursement rates?

No. Medicare payment amounts can vary by locality, facility setting and other payment adjustments.

How can practices reduce CCM claim denials?

Practices should verify eligibility, consent, qualifying time, care plan requirements, staff qualifications, code selection and concurrent billing restrictions before submitting claims.

Final Thoughts

Understanding Chronic Care Management CPT codes and Medicare reimbursement is essential for independent practices operating CCM programs.

Codes 99490, 99439, 99491, 99437, 99487 and 99489 provide different pathways for reporting qualifying standard, practitioner-performed and complex care management services.

Accurate billing requires more than meeting a time threshold. Practices must also address eligibility, patient consent, comprehensive care planning, practitioner responsibilities, qualifying activities and appropriate documentation.

By establishing strong clinical workflows, reviewing claims carefully and evaluating suitable technology, healthcare organizations can support more reliable care management operations.

Reimbursement should follow medically appropriate services actually furnished and documented rather than drive clinical decisions.

Explore ChronicSync: www.chronicsync.com

Official Sources and References

• CMS: Chronic Care Management Services - Medicare Learning Network
• CMS: Chronic Care Management for Complex Conditions
• CMS: Care Management Services
• CMS: 2026 Medicare Physician Fee Schedule Final Rule
• CMS: Physician Fee Schedule Look-Up Tool
• CMS: National Physician Fee Schedule Payment Files
• MedPAC: March 2026 Report to Congress - Physician Payment and Care Management Codes
• Medicare.gov: Chronic Care Management Coverage and Costs
• HHS: HIPAA Security Rule

Disclaimer: This article is provided for educational purposes only and does not constitute medical, legal, coding, billing, reimbursement or compliance advice. CPT is a registered trademark of the American Medical Association. CPT descriptors, Medicare payment rates, claim edits and payer requirements may change. The reimbursement amounts and financial examples are illustrative and do not guarantee payment or profitability. Verify current CMS payment files, Medicare Administrative Contractor guidance and applicable payer rules before submitting claims.