Requirements for CCM

Identifying Chronic Patients

Identify medicare patients who has two or more chronic conditions that are expected to last at least 12 months

Consent Form

Get the advance consent from the patient for the CCM program


Enroll the patients into the CCM program

Certified EHR

Use a certified EHR

Comprehensive Care Plan

Maintain a comprehensive care plan for each patient this is established, implemented, revised or monitored that can also be shared with the patient

Non-Face-to-Face Interaction

Providers must give at least 20 minutes of non-face-to-face care management services during the calendar month

Guidance from Qualified Professional

The clinical staff must be directed by a physician or other qualified healthcare professional

Patient Care

Ensure care providers timely access to patient care

Patient access to Care Plan

Patient needs to be given electronic access to the care plan