Medicare Chronic Care Management
Increase Revenue. Reduce Staff Workload. Improve Patient Outcomes.
Chronic Care Partners works alongside medical providers to help eligible Medicare patients receive consistent follow-up, care coordination, and support between office visits.
Chronic Care Management (CCM) Support
Why Practices Add CCM Support
Patients Need Follow-Up
Chronic care does not stop after the visit. CCM gives eligible patients structured support between appointments.
Staff Time Is Limited
Most practices do not have extra time to manage monthly outreach, coordination, documentation, and monitoring workflows internally.
The Work Can Be Supported
CCM creates a Medicare-recognized structure for between-visit care, with reimbursement available when eligibility and documentation requirements are met.
Actual reimbursement varies by region, payer, patient eligibility, and the codes billed. Not medical, legal, or financial advice.
Why partner
Why Practices Partner Instead Of Building In-House
The gap is between visits
Patients with chronic conditions need support after the appointment, not only during it. That is where follow-through often breaks down.
The monthly work is real
CCM takes outreach, time tracking, follow-up, and documentation every month. Many small practices do not have extra staff capacity for that workload.
The compliance work is real too
Consent has to be documented. Time has to be tracked. Records have to be supportable. CCP is built to handle that structure consistently.
Cost needs an honest explanation
CCM can carry the standard Medicare Part B coinsurance, typically around 20 percent, though many patients with secondary coverage owe little or nothing. It should not be presented as universally free.
CCM Implementation
Add CCM Without Building It Alone
Chronic Care Partners helps support patient outreach, care-plan follow-up, coordination, documentation, and communication so your practice can add CCM structure without turning it into another internal program to manage.
Practice Oversight
Your providers keep clinical direction, patient relationship, and billing-provider oversight. CCP supports the monthly workflow around your practice.
Monthly Work Tracked
Patient outreach, care-plan follow-up, medication-related support, monitoring check-ins, and coordination are handled through a repeatable monthly process.
Clear Patient Consent
Patients need to understand what CCM includes, how the support works, and whether cost-sharing may apply. CCP helps make that conversation clear.
Clinical Support Included
This is not just software. CCP provides clinical support for recurring patient communication, follow-up, and care-management activity.
Built For Practice Capacity
Most practices do not need another program to manage internally. CCP helps add CCM support without requiring your office to hire, train, and supervise a separate team.
Next step
Contact
If you want to know whether CCM fits your workflow and patient panel, the next step is a short conversation.
FAQ
Common Questions From Practice Owners
Is this just software?
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Is this just software?
No. CCP is a fully managed service. The technology matters, but the real value is the clinical outreach, documentation, monitoring support, billing workflow, and monthly execution around it.
Why not run CCM in-house?
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Why not run CCM in-house?
Some practices can. Many do not because it takes staff time, process discipline, and compliance oversight every month. CCP exists for practices that want the work done without building a separate internal program.
Does my practice lose control of the patient relationship?
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Does my practice lose control of the patient relationship?
No. Your practice remains the billing provider of record, keeps clinical judgment, and stays central to the patient relationship. CCP supports the recurring monthly work behind the scenes.
Is there still a revenue opportunity for the practice?
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Is there still a revenue opportunity for the practice?
Yes. CCM and RPM are established Medicare programs. When a patient qualifies and the monthly requirements are met, the practice can bill for those services. The economics help support work that is otherwise hard for a small practice to sustain. Any estimate should be treated as illustrative, not guaranteed.
What does my practice actually have to do?
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What does my practice actually have to do?
Your practice keeps the patient relationship, provides clinical oversight, and remains the billing provider of record. CCP supports patient identification, enrollment, recurring outreach, monitoring workflows, and documentation support.
Can patients opt out?
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Can patients opt out?
Yes. Patients consent before services begin, they can opt out at any time, and only one provider can bill CCM for a patient in a given month.
What do patients pay?
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What do patients pay?
CCM usually carries the standard Part B coinsurance. Many patients with secondary coverage owe little or nothing, but the program should not be described as free across the board.
Next step
Contact
If you want to know whether this fits your patient panel and your workflow, the next step is a short conversation.
We will look at the between-visit care gap in your practice, the work CCP would take off your staff, how enrollment and compliance would run, and the illustrative reimbursement picture if the program fits.
Expect a practical conversation about patient support, monthly workload, compliance, and illustrative reimbursement, not a hard sell.
Booking
Contact
Use this booking form to start a short conversation about fit, workflow, and patient support.