Patient consent capture and EHR documentation
Chronic Care Management Billing Services
CCM Billing, Enrollment, and Revenue Cycle Management
Dastify Solutions helps your practice turn non-face-to-face Medicare care coordination into reliable, recurring revenue without adding administrative burden.
Group practice prior authorization services
CPC-certified coding specialists
Multi-specialty billing services
HIPAA-compliant billing operations
What Is Chronic Care Management and Who Qualifies?
Chronic Care Management is a Medicare Part B service that provides comprehensive care coordination for patients with two or more chronic conditions. With 129 million Americans managing chronic conditions (CDC), Medicare’s CCM program creates a documented, recurring revenue stream for practices providing ongoing care coordination.
Patient eligibility requires:
Two or more chronic conditions expected to last 12 months or longer, or until death
Conditions that pose a substantial risk of death, acute exacerbation, or functional decline
Medicare Part B enrollment
Documented patient consent before the first monthly claim is submitted
Common chronic conditions covered:
Our physician group billing services support organizations operating across multiple providers, locations, specialties, and payer structures. We help healthcare organizations reduce billing inefficiencies, improve operational consistency, and strengthen financial performance.
- Diabetes
- Hypertension
- Heart Disease
- COPD
- Asthma
- Arthritis
- Chronic Kidney Disease
- Depression
- Anxiety Disorders
- Alzheimer’s Disease
Your clinical team delivers the care. We verify eligibility, capture consent, track time and bill accurately so you get paid for the work you are doing.
CCM Billing Compliance Requirements
Patient Enrollment and Consent
Before the first CCM claim, Medicare requires documented patient consent covering the service, cost-sharing, and the right to stop anytime. We manage consent language, capture it in the EHR, and flag patients who have not consented before billing.
Time Documentation Requirements
Medicare requires CCM time to be tracked in real time with the date, duration, and clinical purpose of each interaction. We configure EHR workflows that capture care coordination time and maintain the audit trail Medicare expects.
One Provider Per Month Rule
Medicare allows only one provider to bill CCM for a patient each month. We verify billing history before monthly claims are generated, helping prevent duplicate CCM billing denials.
What We Handle for Your CCM Billing Program
Our CCM billing platform manages the administrative and revenue cycle workload between visits without adding clinical staff burden. Every interaction is documented in real time, keeping your claims compliant and your revenue predictable.
Real-time time tracking and audit-ready logs
CCM CPT coding: 99490, 99439, 99487, 99489, 99491
Monthly claim submission and payer follow-up
Denial management, appeals, and underpayment recovery
Compliance audits and CMS reporting readiness
Chronic Care Management (CCM) CPT Codes and Updated Reimbursement Rates
| CPT Code | Description | 2026 Reimbursement Rate |
|---|---|---|
| 99490 | Standard CCM requires at least 20 minutes of clinical staff time per month for non-face-to-face care management of patients with multiple chronic conditions. | $66.13 per month |
| 99439 | Add-on code for each additional 20 minutes of non-complex CCM services provided by clinical staff. | $50.44 per 20 minutes |
| 99487 | Complex CCM requires at least 60 minutes of care management, including high-intensity or complex care plans. | $144.29 per month |
| 99489 | Add-on code for each additional 30 minutes of complex CCM services provided by clinical staff. | $78.16 per 30 minutes |
| 99491 | The billing practitioner personally provides CCM for at least 30 minutes per month. | $89.00 per month |
CCM billing services for these codes require complete time documentation, documented consent and a current care plan accessible 24/7. Missing any of these triggers claim denial or audit recoupment.
Dastify Solution’s Approach: Compliance-First and Revenue-Driven
We deliver end-to-end CCM billing services designed to protect compliance while maximizing recurring revenue.
Compliance-First Enrollment
We manage consent workflows and eligibility verification so every patient meets CMS requirements before the first claim is submitted.
Precision Time Tracking
We configure EHR workflows to capture every billable minute with audit-ready documentation that survives CMS review.
Accurate Coding and Submission
Our certified coders apply the correct CCM CPT codes, verify add-on code eligibility and submit clean claims monthly.
Denial Prevention and Recovery
We track payer responses, resolve rejections quickly and appeal underpayments to protect your revenue stream.
Revenue Optimization
We analyze your CCM performance monthly, identifying missed add-on codes, documentation gaps and payer-specific billing opportunities that leave money on the table.
Missing Billable CCM Minutes?
The Dastify 5C CCM Billing Framework
We provide tailored chronic care management billing workflows customized to your practice size, payer mix and monthly CCM volume, backed by clear communication and full HIPAA compliance.
Control
Preventing revenue leakage through precise time tracking and accurate code selection.
Compliance
Ensuring every claim meets CMS consent, documentation and billing rules.
Complications
Proactively resolving denials and payer discrepancies before they age into write-offs.
Communication
Clear patient billing statements and consent workflows that reduce disputes and improve collections.
Customization
Payer-specific billing configurations built around your specialty mix, EHR environment and contract terms.
Frequently Asked Questions
What conditions qualify a patient for a CCM program?
Patients are eligible when they have two or more chronic conditions expected to last at least 12 months and are at risk of functional decline, exacerbation or death. Eligible conditions include cardiovascular conditions (hypertension, heart failure), respiratory diseases (COPD, asthma), endocrine and metabolic disorders (diabetes), neurological or renal conditions and other combinations. Clarifying eligibility early ensures proper enrollment, documentation and billing from the first month.
How can a practice implement CCM effectively and ensure reimbursement?
Effective CCM implementation requires enrolling eligible patients with proper documented consent, creating and maintaining individualized care plans covering conditions and goals, tracking non-face-to-face time in real time rather than estimating retroactively, and integrating with EHR systems so billing captures CCM codes and time correctly. Missing any of these steps creates audit exposure and claim denials. We handle the billing, compliance tracking and claim submission so your clinical team can focus on care delivery.
How does billing work when a patient receives CCM from multiple providers?
Medicare allows only one provider to bill CCM per patient per calendar month. When a patient sees multiple providers, the billing provider must be identified and agreed upon before claims are submitted. Billing CCM when another provider has already billed for the same patient in the same month triggers duplicate claim denials and potential recoupment. We verify CCM billing history before every monthly claim generation to prevent this.
Ready to Turn Your CCM Program Into Predictable Monthly Revenue?
Your clinical team is already delivering the care. The only question is whether every billable minute is being captured, coded correctly and submitted on time. We make sure it is.