Can CCM and RPM be Billed Together?

One of the powerful aspects of Medicare care management programs is that some are designed to work together. A primary example is offering Chronic Care Management (CCM) alongside Remote Patient Monitoring (RPM).

CCM and RPM can be billed together when each program independently meets the requirements set by the Centers for Medicare & Medicaid Services (CMS).

But why go to the effort and expense to launch two programs, and how should you practically bill both concurrently? Lastly, what does this look like for Rural Health Clinics and Federally Qualified Health Centers?

Why combine Chronic Care Management and Remote Patient Monitoring programs?

Chronic Care Management provides care coordination services outside of regular office visits. It is for patients with two or more chronic conditions that are expected to last at least 12 months or until the death of the patient. These conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. 

Through monthly touchpoints, the program seeks to provide more accessible, ongoing, and personalized support to Medicare beneficiaries. This can improve treatment, avoid high-cost and -acuity care channels, as well as transition primary care providers toward value-based care.  

Remote Patient Monitoring (RPM) is a Medicare program that monitors patient vitals remotely, using that data to help manage chronic conditions, foster engagement, and develop comprehensive care plans. 

RPM has shown positive outcomes in patient safety, treatment adherence, mobility, and functional status, as well as reducing hospital readmissions and care costs. 

The synergies between CCM and RPM make a powerful diagnostic-therapeutic combination that has been proven clinically effective and profitable. Research studies highlight positive outcomes, particularly in treating diabetes and hypertension.

When combined, providers have regular, robust patient-generated data that equips the care team to intervene earlier or close care gaps, helping to avoid exacerbation and prevent disease progression.

Meet requirements to bill CCM and RPM concurrently

CMS acknowledges the complementary nature of Chronic Care Management and Remote Patient Monitoring by allowing concurrent billing between the two programs. 

RPM can be delivered as a standalone program or alongside programs like CCM, Transitional Care Management, Behavioral Health Integration, and Principal Care Management.   

Offering and billing for CCM and RPM concurrently entails independently meeting each program’s requirements. In particular, activity minutes accrued and submitted for one program or CPT code cannot be used again under a different CPT code. 

For example, minute double-counting is not allowed. As an illustration, time spent under CCM to coordinate patient care (99490) cannot be counted as time a physician spent reviewing RPM data (99457).

In addition to counting time spent in each service separately, other essential guidelines affect one or both programs: 

• An initiating visit by the rendering provider for new patients or those not seen in 12 months. If a patient is a good candidate for a combined CCM-RPM program, both programs should be discussed during the initiating visit. 
• Patient consent to join each program, including cost-sharing and other guidelines
• Documentation of time spent and devices provided in the electronic medical record

• For CCM: The care team must spend a minimum of 20 minutes coordinating care
• For RPM: Patients must take 16 daily readings each month from an integrated device
• For RPM: time-based billing must also meet a separate 20-minute monthly minimum

• For CCM: meant for patients with two or more chronic conditions
• For RPM: a patient can have just one condition, as well as other medical necessities , like post-surgical patients. However, only established patients who have been evaluated by the rendering provider and have a treatment plan can participate.

Both CCM and RPM services can only be billed under one practitioner, even if they use more than one RPM device. Other requirements are specific to the uniqueness of each program, such as device setup and supply of medical devices for RPM. CCM should support comprehensive care plans and 24/7 access to emergency care.

CPT codes and reimbursement rates for CCM and RPM 

Using the appropriate codes for each program is critical. When implementing both programs, it’s crucial to ensure accurate time and device tracking. Make sure to use the correct code when working with more complex patients who may require add-on or physician time.

*The reimbursement rates listed are from the 2025 Physician Fee Schedule. They are based on a national average and may vary by location. See the 2025 Medicare Physician Fee Schedule Final Rule for up-to-date rates.

Can Rural Health Clinics and FQHCs bill CCM and RPM together?

Yes. Introduced in the 2025 Physician Fee Schedule, rural health clinics and federally qualified health centers can now bill individual CPT and HCPCS codes that describe care coordination services.

ThoroughCare streamlines billing and management of CCM and RPM 

Providers can manage care management programs with ThoroughCare. As a comprehensive software platform, ThoroughCare streamlines care management across all program types by automatically accounting for Medicare’s rules and requirements while documenting service records. 

Our end-to-end workflow simplifies billing for Chronic Care Management and Remote Patient Monitoring, providing a structured approach to care management while enabling flexibility to meet individual patient needs. 

Key questions answered

Can providers bill CCM and RPM concurrently?

Yes, most providers can provide and bill for Chronic Care Management and Remote Patient Monitoring programs concurrently as long as they can meet the requirements for each program independently. 

What are the rules that enable billing CCM and RPM together?

The main requirements for CCM and RPM are eligibility and enrollment, service time required each month, and documentation and billing. Some rules are required by both programs and others are unique to each program.