Chronic Care Management in California.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, Medi-Cal coverage, and compliance details for California providers.
How does CCM work for providers in California?
Chronic Care Management (CCM) enables California providers to bill Medicare for non-face-to-face care coordination using CPT codes 99490, 99491, 99439. Patients with two or more chronic conditions qualify — common combinations in California include diabetes, heart disease, hypertension. Medicare covers CCM federally for patients with 2+ chronic conditions. Medi-Cal provides full supplementary coverage. Serving 6.5M seniors with +23% by 2035 projected growth, California's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 6+ major health systems including Kaiser Permanente and Sutter Health running CCM programs.
Medicare Billing
CCM billing in California.
CCM uses federally standardized CPT codes with uniform reimbursement across California. Medi-Cal provides full supplementary Medicaid coverage for dual-eligible patients.
CCM services, first 20 min of clinical staff time per month
CCM services requiring physician/QHP, first 30 min/month
Each additional 20 min of CCM clinical staff time
~$80-$130/mo per patient
20 minutes of non-face-to-face care coordination per month (99490); 30 minutes for complex CCM (99491)
Medicare covers CCM federally for patients with 2+ chronic conditions. Medi-Cal provides full supplementary coverage.
Billing Requirements
Patient must have two or more chronic conditions expected to last at least 12 months
Comprehensive care plan must be established and maintained
Patient consent documented in medical record
24/7 access to care team required
Continuity of care with designated practitioner
California Medicaid Supplement
Medi-Cal provides full supplementary coverage for dual-eligible CCM patients. Providers can bill both Medicare and Medicaid to maximize reimbursement for CCM services. California's telehealth parity law supports remote CCM delivery at equivalent reimbursement rates.
California-Specific Billing Considerations
California Consumer Privacy Act compliance required
Enhanced patient consent requirements
Regulatory Landscape
CCM compliance in California.
Beyond federal Medicare requirements, California has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Telehealth Parity
- *California has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits.
- *California has comprehensive telehealth parity laws. RPM is reimbursed at in-person rates for most payers.
Interstate Licensure
- *California is not currently a member of the Interstate Medical Licensure Compact. Providers delivering CCM services must hold a valid California medical license.
State Privacy Law
- *CCPA/CPRA applies to care coordination records and patient communication data stored during CCM activities.
- *Shared care plans must comply with both HIPAA and CCPA/CPRA data handling requirements.
Additional Requirements
- *California Consumer Privacy Act compliance required
- *Enhanced patient consent requirements
EHR Integrations
CCM-compatible EHRs.
Major California health systems like Kaiser Permanente and Sutter Health use EHR platforms that CCN Health integrates with. Each integration includes automated CCM documentation, billing, and clinical workflows.
PointClickCare
665 integration guides
ALIS
663 integration guides
MatrixCare
663 integration guides
August Health
663 integration guides
Ethizo
240 integration guides
athenahealth
240 integration guides
Charm Health
240 integration guides
Epic
240 integration guides
FAQ
CCM in California questions.
California's dense healthcare market and 6+ major health systems like Kaiser Permanente and Sutter Health create strong infrastructure for CCM adoption. Medi-Cal provides full supplementary coverage, maximizing dual-eligible revenue. High prevalence of diabetes, heart disease, hypertension among California's patient population drives CCM enrollment.
Medi-Cal provides full supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. Medi-Cal provides full supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
California has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits. California has comprehensive telehealth parity laws. RPM is reimbursed at in-person rates for most payers.
With 6.5M residents aged 65+, California has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in California include diabetes with heart disease, and hypertension with diabetes. California's +23% by 2035 senior population growth means CCM demand is accelerating. California's high Medicare Advantage penetration means many seniors are already enrolled in plans that support CCM.
California has approximately 6.5M residents aged 65+ (16.4% of the population), with +23% by 2035 projected growth. Largest Medicare market in the US. Strong telehealth adoption in urban areas. Medi-Cal expansion provides broad coverage for dual-eligible populations.
CCM in California must comply with federal Medicare billing requirements and HIPAA. California's CCPA/CPRA adds state-level data protection requirements for patient health information collected through CCM devices and platforms. California is not part of the Interstate Medical Licensure Compact — providers must hold a valid California license to deliver CCM services. Additional California-specific requirements include: California Consumer Privacy Act compliance required; Enhanced patient consent requirements. California has comprehensive telehealth parity laws. RPM is reimbursed at in-person rates for most payers.
This page provides general informational guidance only and does not constitute legal, compliance, or billing advice. Telehealth regulations, Medicaid coverage, and state privacy laws change frequently. Verify current requirements with your state health department, payers, and qualified healthcare compliance counsel before making program decisions. Demographic data is based on U.S. Census Bureau estimates. Data last verified: March 2026.
Other Programs
More programs in California.
Explore other Medicare remote care programs available to California providers.
RPM
Remote Patient Monitoring
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PCM
Principal Care Management
Focused management of a single high-complexity chronic condition.
BHI
Behavioral Health Integration
Behavioral health screening and collaborative care in primary care settings.
RTM
Remote Therapeutic Monitoring
Therapy outcome monitoring for musculoskeletal and respiratory rehabilitation.