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September 8, 2026

REMINDER: Chronic Care Management (CCM) and Transitional Care Management (TCM) Services

We've recently seen an increase in provider inquiries related to billing and submission requirements for Chronic Care Management (CCM) and Transitional Care Management (TCM) services. To help address common questions, please review the following information from the CMS Chronic Care Management Fact Sheet:

  • As stated on page 1 of the CMS CCM Fact Sheet, Chronic Care Management services consist of at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.
  • Page 9 of the CMS CCM Fact Sheet further clarifies that CPT code 99490 (CCM) cannot be billed during the same calendar month as any of the following:
    • CPT codes 99495–99496 (Transitional Care Management)
    • HCPCS codes G0181/G0182 (Home Health Care Supervision/Hospice Care Supervision)
    • CPT codes 90951–90970 (certain End-Stage Renal Disease services)

Please also consult the CPT Manual for additional codes that cannot be billed during the same service period as CPT code 99490. Additional restrictions may apply for practitioners participating in CMS-sponsored models or demonstration programs.

Claims should be submitted with the date of service on which the 20-minute requirement was fulfilled.

CCM Services Fact SheetExternal PDF

TCM Services Fact SheetExternal PDF

CGS, Part B – Browse by Topic (Chronic Care Management)

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