Skip to content Credex Healthcare delivers CCM billing services that help primary care practices, internal medicine groups, and federally qualified health centers capture the monthly Medicare reimbursement they have already earned through chronic care management. Most practices leave CCM revenue uncollected, not because they are not doing the work but because the monthly billing workflow, time-documentation requirements, and patient-consent standards are not set up correctly. Our CCM billing specialists fix that.
We at Credex Healthcare cover everything from patient eligibility verification and consent documentation through claim submission, denial follow-up, and monthly reporting to complete CCM revenue cycle management.
First-pass claim submissions success rate
Average turnaround time for CCM billing
Medicare, Medicaid & commercial networks
Patient enrollment & consent management
Credex Healthcare runs a dedicated chronic care management billing process built around Medicare’s CCM requirements: a minimum of 20 minutes of clinical staff time per calendar month, a structured care plan in the EHR, patient consent documented before services begin, and a qualifying diagnosis from the ICD-10 chronic condition list. Our CCM billing specialists check each of those elements before a claim is filed. Incomplete time logs, unsigned consent forms, and missing care plan updates are the three most common reasons. CCM claims are denied or retracted during an audit. We catch all three before submission.
We cover all the following in our CCM billing services in the USA:
CCM claims go out each month with verified-time documentation, correct CPT code selection, and supporting care plan data. Our team keeps an eye on the decision-making process in real time and follows up on any claim before the deadline for filing becomes a risk.
We screen your patient panel for CCM eligibility per Medicare CCM requirements, track written consent status, and flag any patient whose consent was not documented before services began, protecting your practice from retroactive denials.
We look over denied CCM claims within 48 hours. Our team figures out if the rejection was due to a lack of time for paperwork, a care plan that is missing information, or duplicate billing. They then fix the problem and resubmit it with the right supporting documentation.
Our certified coders verify CPT code selection across 99490, 99439, 99487, and 99489 based on documented time. Care plan documentation requirements are reviewed against each payer's CCM compliance requirements before submission.
We manage provider enrollment for your billing physicians and clinical staff with Medicare and Medicaid programs, ensuring your CCM services are billed under correctly enrolled providers, and your group NPI is accurately applied.
End-to-end RCM includes keeping track of new patients, reviewing time logs monthly, entering charges and posting payments, and providing monthly financial reports. This way, practice managers can see exactly how much money the CCM program is making every billing cycle.
Credex Healthcare is a dedicated CCM billing company in the USA. They keep up with changes to Medicare’s CCM requirements as they happen, as well as how Medicaid programs in different states handle chronic care management reimbursement. They also keep up with how CCM billing compares to remote patient monitoring billing under CPT 99453, 99454, and 99457. CCM and RPM are often used together, but they have different time requirements, different CPT codes, and different documentation standards. Billing them incorrectly against each other is one of the most common compliance errors in chronic care programs.
Medicare covers CCM under Part B for patients with two or more chronic conditions expected to last 12 months. We manage monthly billing under 99490, 99439, 99487, and 99489 with full documentation review and time verification before every claim.
Remote patient monitoring vs. CCM billing requires different CPT codes, different time-counting rules, and different consent documentation. Our team bills each program correctly and separately, preventing the overlap errors that trigger CMS audits.
For group practices with multiple billing physicians supervising CCM programs, we coordinate provider-level billing, supervising physician requirements, and monthly time-log reconciliation across the entire practice panel.
Federally Qualified Health Centers and Rural Health Clinics bill CCM under different cost-based reimbursement rules. Credex Healthcare handles CCM billing for both practice types, applying the appropriate billing methodology for each.
CCM claims fail during audit when time logs are incomplete, care plans are not updated, or patient consent was never properly documented. Every Medicare CCM billing requirement must be met before a claim is submitted. Credex Healthcare verifies each one.
We review your patient panel against Medicare CCM requirements: two or more chronic conditions, Medicare Part B enrollment, no conflicting CCM billing from another provider in the same month, and no concurrent Transitional Care Management billing.
A comprehensive care plan covering problem list, medication management, community resources, and care coordination goals must be in the EHR before CCM is billed. We review care plan documentation requirements for compliance before each monthly billing run.
Time Log Verification
CPT 99490 requires 20 minutes of clinical staff time per month. CPT 99439 adds each additional 20 minutes. CPT 99487 requires 60 minutes of complex CCM time. We verify time logs against these thresholds before code selection on every claim.
Patient Consent Documentation
Written patient consent must be on file before CCM services begin and must document the scope of services, cost-sharing obligations, and the patient's right to stop at any time. We track consent status across your enrolled CCM population.
Compliance Requirements for CCM
CMS compliance requirements for CCM include 24/7 access documentation, care transition management, and medication reconciliation records. We audit claims against these requirements, so your program is not exposed to retroactive recoupment.
Following up on Accounts Receivable
Monthly CCM AR is reviewed for each billing cycle. Our specialists pursue all unpaid claims before the timely filing limits close; underpayments are checked against the Medicare fee schedule, and any pattern of repeated denials is addressed at the documentation level.
A lot of general care offices have a CCM program, but they only get a small part of the money it should bring in. Staff do not check time logs or update care plans, and they process monthly payments without verifying that the paperwork meets Medicare’s standards. The way Credex Healthcare bills for chronic care management includes these checks in every month’s cycle.
Filing claims for chronic care management from start to finish, including review of patient panels, proof of time logs, choice of CPT codes, and computerized filing of claims to Medicare, Medicaid, and private payers for each billing cycle.
Our CCM billing experts use 99490, 99439, 99487, and 99489 based on confirmed time documentation and care plan status. This cuts down on rejections that happen because the wrong code was chosen or there isn't enough care to plan paperwork.
Consent & Enrollment Tracking
Every month, the state of patient permission and CCM registration is checked. New patients are checked to see if they are eligible; breaks in permission are marked before billing, and patients who have been released are quickly taken off the current billing list.
Resolving time-log disagreements, care plan deficiencies, and duplicate billing issues are all part of CCM claims denial management. Each appeal is based on the exact reason for the rejection and includes the exact proof that CMS needs.
Provider application management includes billing, physician registration, overseeing provider requirements for incident-to CCM billing, and group practice NPI applications. This makes sure that your billing stays legal according to the latest CMS rules.
The number of registered patients, the average number of minutes per patient, rejection trends, and the time it takes to bill for CCM services are all shown in monthly reports. This information helps program managers run and grow the program.
Years of CCM Billing Expertise
Provider Enrollment & Credentialing Success
Claim Compliance Rate Across All Payers
Support Available for All Your Needs
Customized CCM Revenue Cycle Solutions
MD
Miriam
“We had 180 patients signed up for CCM, but only got about 60 of them every month. Credex checked the program and found that most people had not signed permission forms or completed their time logs. They fixed the flow of work and caught up on the paperwork, and in two months we went from charging 60 people to 160. That was money we were making anyway but not getting.”
Practice Administrator
Frank
“It was harder to keep track of paperwork than it was to bill when I ran CCM billing for six doctors.” It was different for each doctor to fill out the time logs, and the care plans were not being changed as planned. Credex puts a review into the payment loop that happens every month and finds those holes before claims are sent out. The number of denials dropped quickly, and the monthly CCM income level stabilized.”
DO
Strauss
CFO
Ihejirika
“Across four clinic sites, we have been billing CCM in different ways. There were sites that did it right and sites that did not. Credex made the payment and paperwork process the same at all four sites. They also created a monthly report that shows how much CCM income each location brings in. Now I can see where each location stands every month without asking anyone to pull numbers manually.”
MD
Launa
“Most of my patients are older and have complicated health problems; most of them are eligible for CCM. The trouble was that we didn’t have a way to keep track of the 20-minute mark. Credex linked to our EHR and set up the time tracking correctly. Every month, Credex bills all of our qualified patients. We have experienced meaningful improvements in our reimbursement in our monthly collections.”
Practice Assessment
We look at how your present CCM program is set up, including the number of registered patients, the state of the permission paperwork, how the EHR time-tracking is set up, how full the care plan is, and your past billing history. This shows the program's money-losing spots and what needs to be fixed first.
Screening for Patient Eligibility
We check your live patient list to see if they are eligible for CCM based on Medicare's rules. We flag patients who are registered without their permission or who have a CCM claim from another provider in the same month.
Care Plan & Consent Audit
Active care plans are reviewed for completeness against CMS documentation standards. Consent forms are verified for each enrolled patient. Gaps are flagged to your clinical team before the first billing runs.
Monthly CCM Claims Submission
At the close of each calendar month, our CCM billing specialists review time logs, verify CPT code selection, and submit claims electronically to Medicare, Medicaid, and applicable commercial payers for every qualifying patient.
Denial Management & Follow-Up
Denied claims are reviewed within 48 hours. Time documentation disputes, care plan deficiency rejections, and duplicate billing conflicts are each corrected with a targeted response and resubmitted with the appropriate supporting records.
Monthly Reporting & Optimization
Each billing cycle closes with a report covering enrolled patient count, claims submitted, revenue collected, denial reasons, and billing turnaround time for CCM services. Recurring issues are corrected in the documentation workflow, not just in the billing.
CCM is one of the few Medicare programs that pays practices monthly for care coordination work the clinical team is already doing. The problem is that the monthly billing workflow, time-documentation standards, care plan requirements, and patient-consent rules make it easy to bill incorrectly or incompletely. Credex Healthcare’s CCM revenue cycle management is built specifically around those requirements, so your program collects what it should every month.
Our team works on chronic care management billing daily. We know the CPT code thresholds, the care plan documentation requirements, the CMS compliance rules for 24/7 access and care transitions, and the monthly billing workflow required by Medicare. CCM billing is not treated here as a variation of standard E&M billing.
Your practice works with one dedicated CCM billing specialist who understands your patient panel, EHR setup, enrolled providers, and the program's billing history. Issues are resolved by someone who already knows the context.
Practice administrators see enrolled patient counts, claims submitted, revenue collected per provider, denial reasons, and average minutes per patient in clear monthly reports. The data reflects the actual state of your CCM program, not a summary.
CCM involves ongoing access to patient health records for care coordination. All data handling in our billing process adheres to full HIPAA compliance protocols with documented security standards and limited access controls applied throughout.
Most practices that have a CCM program are paid less than half of what their enrolled patients are eligible for each month. Your clinical staff’s revenue decreases when they don’t have complete time logs, do not sign consent forms, use outdated care plans, or generate monthly bills without reviewing the documentation.
Credex Healthcare begins with a free review of your current CCM program, which includes the number of enrolled patients, their consent status, the completeness of their care plans, time logs, and billing history. You do not have to make a commitment to get that review. Before you make any decisions, we show you the dollar difference between what your program is collecting and what it should be collecting.
CCM billing is the monthly claims process for Chronic Care Management services under Medicare. Practices bill for clinical staff time spent on care coordination, medication management, and care planning for patients with two or more chronic conditions. A claim is filed at the end of each calendar month once the minimum time threshold is met and documentation requirements are satisfied.
CCM uses four main CPT codes. CPT 99490 covers the first 20 minutes of clinical staff’s CCM time per calendar month and is the standard monthly CCM code. CPT 99439 is an add-on code billed for each additional 20 minutes beyond the first, up to 2 add-on units per month. CPT 99487 is used for complex CCM cases requiring 60 minutes or more of clinical staff time and involving multiple revisions to the care plan.
Yes. Medicare Part B covers CCM for beneficiaries with two or more chronic conditions that are expected to last at least 12 months and that place the patient at significant risk of death, acute exacerbation, or functional decline. The treating physician or qualified non-physician practitioner must initiate the CCM service, document a care plan in the EHR, and obtain written patient consent. Medicare reimburses CCM monthly once the time threshold is met.
Medicare CCM payments vary by location. As of 2025, the national average for CPT 99490 is about $62 per patient per month for 20 minutes of simple CCM. CPT 99439 pays about $47 for every extra 20 minutes. For a complicated CCM that takes 60 minutes, CPT 99487 pays about $131. CPT 99489 adds about $70 for every extra 30 minutes of complex CCM time.
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At Credex Healthcare, we know how frustrating it is when claims are denied. That is
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