What is chronic care management?

Chronic Care Management (CCM) is defined by the Centers for Medicare and Medicaid Services (CMS) as coordinating care for patients with multiple chronic conditions outside regular office visits. These conditions are expected to last at least 12 months or until the patient passes away.

What are the benefits of chronic care management?

CCM helps practices create personalized care plans, improve adherence to care guidelines, streamline documentation, and support a more efficient billing workflow. The goal is to improve outcomes, reduce complications, and stay aligned with CMS requirements.

How does chronic care management work?

CCM typically includes patient enrollment, creation of a care plan, ongoing monthly care coordination and patient communication, and accurate documentation for billing and reimbursement.

What services are included in chronic care management?

CCM services can include identifying chronic conditions, developing care plans, coordinating referrals, reviewing results, medication support, documenting monthly communication time, and recording billable actions for compliance.

What are Chronic Care Management CPT codes?

CCM CPT codes are billing codes used to report chronic care management services. Common codes can include 99490, 99439, 99487, 99489, 99491, and related codes, depending on the service level and time.

How do Chronic Care Management CPT codes work?

Practices use CCM codes to bill for specific care coordination services based on eligibility, documented activities, and time thresholds. Proper documentation supports accurate reimbursement and transparency for the care delivered.

2026 Medicare Update: How The New BHI Codes Could Boost APCM Profitability

Mario Erlach
August 14, 2025

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The Centers for Medicare and Medicaid Services (CMS) is proposing key changes to the 2026 Medicare Physician Fee Schedule that could significantly increase the profitability of Advanced Primary Care Management (APCM), especially for practices offering behavioral health support. For the first time, new optional G-codes will allow practices to bill for Behavioral Health Integration (BHI) or Collaborative Care Model (CoCM) services in the same month as APCM. This proposed shift in billing and reimbursement offers to unlock previously untapped revenue for healthcare providers, making it a pivotal change in the future of care delivery.

Why This Matters

Up until now, most practices don’t usually offer BHI because similar services can be billed at higher rates under Chronic Care Management (CCM). With the new CMS proposal, this won’t be the case any longer. In 2026, APCM participants will be able to bill for both APCM and BHI/CoCM services simultaneously. This change not only allows you to expand care delivery for your patients but also increases reimbursement potential for your practice.

What the New G-Codes Do

CMS is proposing new G-codes, GPCM1, GPCM2, and GPCM3, that mirror existing BHI and CoCM CPT codes but with less administrative complexity. Here’s what makes these new G-codes a significant win for providers:

Feature	Current Rule	With Proposed G-Codes
No time-tracking requirements	BHI and CoCM CPT codes (e.g., 99484, 99492) require a minimum number of minutes (20, 60, or 70) of care team time per month to qualify for billing.	Reimbursement will now be based on the service provided, moving away from time-based billing. This reduces documentation burden, simplifies billing, and encourages broader adoption.
Allows dual billing with APCM	If you bill for APCM, you generally can’t bill separately for BHI or CoCM in the same month, even if both are provided.	Practices can bill for both BHI/CoCM and APCM in the same month, allowing for reimbursement of both services without having to choose one over the other.

A Quick Look at the Current CPT Codes

Here’s a breakdown of the existing CPT codes that the new G-codes are modeled after:

CPT Code	Description	Time Requirement
99484	General BHI care management	≥20 min/month
99492	Initial CoCM month	70 min
99493	Subsequent CoCM month/s	60 min
99494	Add-on (each additional 30 min)	+30 min
G0512	FQHC/RHC CoCM (with G0511)	30 min

These codes support behavioral care coordination delivered by clinical staff under the supervision of a physician or a qualified healthcare professional. With the proposed G-codes, practices can bill more efficiently by removing strict time tracking and bundling requirements.

How This Impacts Your Practice

Increased reimbursement opportunities – Practices can now bill for behavioral and primary care services simultaneously under APCM.
Reduced administrative burden – The new G-codes are not time-based, making documentation and billing easier.
Expanded care offerings – You can offer meaningful behavioral health support without sacrificing revenue or adding billing complexity.

Next Steps for Providers

If you’re enrolled in APCM or leaning towards it, here are a few things to consider next:

Evaluate your care workflows – Do they include behavioral health support that could qualify for BHI/CoCM billing?
Plan for 2026 integration – Anticipate how these changes could improve patient care and your bottom line.
Align with the 13 APCM elements – Our model at RPM Logix already checks all the boxes. See how we do it in this article.

Want to learn more?

RPM Logix offers a complete outsourced solution for a dual APCM / BHI Program.

To be eligible to bill APCM codes, you must meet all of the 13 required service elements.

RPM Logix’s platform meets all the required service elements, including the most challenging ones, which involve Population Health and Care Gap reporting.

Our Care Team, featuring nurses, registered dietitians, and certified diabetes educators, can extend your APCM program to provide BHI services. This could amount to over $150 in combined reimbursement per patient each month.

📞 Interested? Schedule a strategy call or fill out the form below to get started with a demo.

Mario Erlach

Founder at RPM Logix – Remote Personalized Medicine

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Disclaimer

The information provided by RPM Logix is intended for educational purposes only and should not be construed as legal or medical billing advice. While every effort is made to ensure the accuracy and timeliness of the content, RPM Logix makes no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability of the information provided. The coding and billing guidelines, including but not limited to CPT, HCPCS, and ICD codes, are subject to updates and changes by regulatory authorities such as CMS (Centers for Medicare & Medicaid Services) and the AMA (American Medical Association).
RPM Logix is not responsible for any errors, omissions, or outcomes resulting from the use of this information. It is the responsibility of the healthcare provider to verify the accuracy of coding and billing information, to remain informed about updates, and to comply with all relevant payer guidelines and regulations. RPM Logix strongly recommends consulting legal counsel, reimbursement specialists, or the appropriate authoritative resources before submitting any claims.
By using the information provided by RPM Logix, you acknowledge and agree that RPM Logix shall not be held liable for any claims, damages, or other liabilities arising from your use of the information, including but not limited to any billing, coding, or reimbursement issues that may result from reliance on the material presented.

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