Chronic Care Management in Ohio.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, Ohio Medicaid coverage, and compliance details for Ohio providers.
How does CCM work for providers in Ohio?
Chronic Care Management (CCM) enables Ohio 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 Ohio include heart disease, diabetes, COPD. Medicare covers CCM federally for patients with 2+ chronic conditions. Ohio Medicaid provides partial supplementary coverage. Serving 2.1M seniors with +10% by 2035 projected growth, Ohio's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 5+ major health systems including Cleveland Clinic and OhioHealth running CCM programs. As an Interstate Medical Licensure Compact member, Ohio facilitates cross-state CCM delivery.
Medicare Billing
CCM billing in Ohio.
CCM uses federally standardized CPT codes with uniform reimbursement across Ohio. Ohio Medicaid provides partial 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. Ohio Medicaid provides partial 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
Ohio Medicaid Supplement
Ohio Medicaid provides partial supplementary coverage — check current Ohio Medicaid fee schedules for dual-eligible CCM rates.
Regulatory Landscape
CCM compliance in Ohio.
Beyond federal Medicare requirements, Ohio has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Interstate Licensure
- *Ohio is a member of the Interstate Medical Licensure Compact, enabling physicians licensed through the compact to provide CCM services across state lines.
EHR Integrations
CCM-compatible EHRs.
Major Ohio health systems like Cleveland Clinic and OhioHealth 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 Ohio questions.
Ohio's mix of urban centers and rural communities means CCM serves both high-volume practices affiliated with systems like Cleveland Clinic and OhioHealth and remote clinics where in-person visits are difficult. Ohio Medicaid offers partial supplementary coverage for dual-eligible patients. Ohio's membership in the Interstate Medical Licensure Compact enables cross-state CCM delivery. High prevalence of heart disease, diabetes, COPD among Ohio's patient population drives CCM enrollment.
Ohio Medicaid provides partial supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. Ohio Medicaid provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
With 2.1M residents aged 65+, Ohio has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in Ohio include heart disease with diabetes, and COPD with heart disease. Ohio's +10% by 2035 senior population growth means CCM demand is accelerating. Ohio's high Medicare Advantage penetration means many seniors are already enrolled in plans that support CCM.
Ohio has approximately 2.1M residents aged 65+ (18% of the population), with +10% by 2035 projected growth. Cleveland Clinic influence drives innovation adoption. Strong skilled nursing presence. Rural areas particularly benefit from remote monitoring capabilities.
CCM in Ohio must comply with federal Medicare billing requirements and HIPAA. Ohio does not currently have a comprehensive state privacy law beyond HIPAA, but standard patient consent and data security requirements apply. As an Interstate Medical Licensure Compact member, Ohio allows compact-licensed physicians to deliver CCM services across state lines. Ohio has comprehensive telehealth coverage. Strong support for chronic care management programs.
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 Ohio.
Explore other Medicare remote care programs available to Ohio 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.