Who Pays for Chronic Care Management?

Who Pays for Chronic Care Management (CCM) services?

  • Chronic Care Management (CCM) services are an insurance benefit and will be covered 80% by Medicare and other insurances. The remaining 20% will be the patient’s responsibility which equals around $8 per month.
  • Sometimes, supplemental insurance in addition to Medicare may cover some or all of the $8 per month copay. You will need to check with your individual insurance for coverage questions.
  • A bill will be submitted to Medicare only when billable services have been provided and may be as often as every month.
  • Please remember that only one physician can bill for this service per month. This physician will oversee your chronic care needs and work in conjunction with your other healthcare providers.
  • Medicare, in some instances, does not allow CCM services to be billed for when specific other services have been provided in a given month.
  • You can opt out of CCM services at any time by notifying the physician’s office that you signed up with for this service.
  • You will receive a bill from The Austin Diagnostic Clinic (ADC) if any amount is due that has not been covered by Medicare or other insurance.

Download: Who pays for chronic care management? (PDF)