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 Reimbursement for RPM and CCM Increases by 7-21%

Mario Erlach
December 19, 2025

Table of Contents

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Key Takeaways

CMS increased RPM and CCM reimbursement rates by 7–21% for 2026.
New billing codes expand the revenue potential of remote care programs.
Practices can convert previously uncompensated care management work into billable services.
RPM programs create scalable recurring revenue streams.
Integrating RPM and CCM strengthens patient outcomes while improving practice profitability.

The release of the 2026 Physician Fee Schedule (PFS) Final Rule signals a major victory for forward-thinking practices. For the upcoming year, CMS has finalized substantial updates that will see reimbursement for Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Advanced Primary Care Management (APCM), and Behavioral Health Integration (BHI) increase by approximately 7-21%. For years, providers have navigated the “16-day hurdle” for remote monitoring and the rigid 20-minute care management requirement. In 2026, CMS is finally lowering these barriers, recognizing that high-impact care happens in smaller, more frequent increments. At RPM Logix, we’ve decoded the final rule to help you capture this expanded revenue while we handle the operational burden of these new requirements.

RPM (Remote Patient Monitoring)

Here’s what you need to know about the two new RPM codes on the books for 2026:

CPT 99445: You can now bill for device supply and data transmission for as few as 2 to 15 days of readings. The reimbursement will be $52.11, same as existing CPT Code 99454. CMS recognized that there is significant clinical benefit for patients even when testing biometrics as little as 2 days per month.

CPT 99470: CMS now recognizes clinical management sessions between 10–19 minutes. This allows your team to bill for the quick, high-value alerts and care plan adjustments that were previously uncompensated.

Summary of 2026 Reimbursement for Remote Patient Monitoring

CPT	Description	2026 REIMBURSEMENT
99453	Device Setup	$21.71
99445	2-15 Days of Device Readings	$52.11
99454	16+ Days of Device Readings	$52.11
99470	Care Team 10-19 Mins	$26.05
99457	Care Team First 20 Mins	$51.77
99458	Care Team Ea Addtl 20 Mins	$41.42

CCM (Chronic Care Management)

All codes remain the same, but reimbursement increases by 7-21%.

Summary of 2026 Reimbursement for Chronic Care Management

CPT	Description	2026 REIMBURSEMENT
99490	Care Team First 20 Mins	$66.13
99439	Care Team Addtl 20 Mins	$50.44
99487	Complex CCM First 60 Mins	$144.29
99489	Complex CCM Ea Addtl 30 Mins	$78.16

APCM Meets Whole-Person Care: The BHI Integration

Advanced Primary Care Management (APCM) is being elevated as the premier model for longitudinal health. While APCM codes will also increase by 7-21%, you will also be able to bill Behavioral Health Integration (BHI) as add-on codes alongside APCM base codes. Read more about this HERE.

For patients struggling with chronic conditions, the mental health component is often as critical as the physical vitals. This update allows you to leverage interdisciplinary teams, including our credentialed educators and nurses, to treat the whole patient while securing the additional revenue that integrated care deserves.

Summary of 2026 Reimbursement for Advanced Primary Care Management

CPT	Description	2026 REIMBURSEMENT
G0556	APCM Level 1	$16.37
G0557	APCM Level 2	$53.78
G0558	APCM Level 3	$117.24

Please note that to be compliant in billing APCM, all required 13 APCM elements must be met. RPM Logix has you covered on this, with a robust Population Health Module and Care Gap reporting capabilities.

Summary of 2026 Reimbursement for Behavioral Health Integration

CPT	Description	2026 REIMBURSEMENT
99484	Behavioral Health Integration	$51.77
99492	Initial CoCM month	$160.32
99493	Subsequent CoCM month/s	$144.96
99494	Add-on / ea. addtl 30 min	$61.46

The Bottom Line: Proactive vs. Reactive Care

The 2026 Final Rule isn’t just about higher rates; it’s about a shift toward non-facility, office-based care. As CMS reduces facility-based incentives, the financial advantage shifts toward practices that can manage patients effectively in the comfort of their home.

Is your practice ready to transition from uncompensated work to a scalable, remote revenue stream?

Schedule a 2026 Revenue Analysis with RPM Logix and see exactly how our full-service care team can turn these CMS updates into a clinical and financial engine for your practice.

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).
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