Chronic Care Management in New York.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, NY Medicaid coverage, and compliance details for New York providers.
How does CCM work for providers in New York?
Chronic Care Management (CCM) enables New York 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 New York include heart disease, diabetes, COPD. Medicare covers CCM federally for patients with 2+ chronic conditions. NY Medicaid provides full supplementary coverage. Serving 3.4M seniors with +15% by 2035 projected growth, New York's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 5+ major health systems including NewYork-Presbyterian and Northwell Health running CCM programs.
Medicare Billing
CCM billing in New York.
CCM uses federally standardized CPT codes with uniform reimbursement across New York. NY Medicaid 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. NY Medicaid 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
New York Medicaid Supplement
NY Medicaid provides full supplementary coverage for dual-eligible CCM patients. Providers can bill both Medicare and Medicaid to maximize reimbursement for CCM services. New York's telehealth parity law supports remote CCM delivery at equivalent reimbursement rates.
New York-Specific Billing Considerations
SHIELD Act data security requirements
Enhanced breach notification requirements
Regulatory Landscape
CCM compliance in New York.
Beyond federal Medicare requirements, New York has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Telehealth Parity
- *New York has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits.
- *New York has strong telehealth parity laws established during COVID-19 and made permanent. Active in value-based care initiatives.
Interstate Licensure
- *New York is not currently a member of the Interstate Medical Licensure Compact. Providers delivering CCM services must hold a valid New York medical license.
State Privacy Law
- *NY SHIELD Act applies to care coordination records and patient communication data stored during CCM activities.
- *Shared care plans must comply with both HIPAA and NY SHIELD Act data handling requirements.
Additional Requirements
- *SHIELD Act data security requirements
- *Enhanced breach notification requirements
EHR Integrations
CCM-compatible EHRs.
Major New York health systems like NewYork-Presbyterian and Northwell 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 New York questions.
New York's dense healthcare market and 5+ major health systems like NewYork-Presbyterian and Northwell Health create strong infrastructure for CCM adoption. NY Medicaid provides full supplementary coverage, maximizing dual-eligible revenue. High prevalence of heart disease, diabetes, COPD among New York's patient population drives CCM enrollment.
NY Medicaid provides full supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. NY Medicaid provides full supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
New York has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits. New York has strong telehealth parity laws established during COVID-19 and made permanent. Active in value-based care initiatives.
With 3.4M residents aged 65+, New York has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in New York include heart disease with diabetes, and COPD with heart disease. New York's +15% by 2035 senior population growth means CCM demand is accelerating. New York's high Medicare Advantage penetration means many seniors are already enrolled in plans that support CCM.
New York has approximately 3.4M residents aged 65+ (17.5% of the population), with +15% by 2035 projected growth. Dense urban population with sophisticated healthcare infrastructure. Strong adoption of RPM in skilled nursing and home health. Value-based care models drive preventive monitoring.
CCM in New York must comply with federal Medicare billing requirements and HIPAA. New York's NY SHIELD Act adds state-level data protection requirements for patient health information collected through CCM devices and platforms. New York is not part of the Interstate Medical Licensure Compact — providers must hold a valid New York license to deliver CCM services. Additional New York-specific requirements include: SHIELD Act data security requirements; Enhanced breach notification requirements. New York has strong telehealth parity laws established during COVID-19 and made permanent. Active in value-based care initiatives.
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 New York.
Explore other Medicare remote care programs available to New York providers.
RPM
Remote Patient Monitoring
Real-time vital sign monitoring with FDA-cleared cellular devices.
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.