Chronic Care Management in Rhode Island.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, RI Medicaid coverage, and compliance details for Rhode Island providers.
How does CCM work for providers in Rhode Island?
Chronic Care Management (CCM) enables Rhode Island 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 Rhode Island include heart disease, diabetes, COPD. Medicare covers CCM federally for patients with 2+ chronic conditions. RI Medicaid provides partial supplementary coverage. Serving 0.2M seniors with +10% by 2035 projected growth, Rhode Island's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 4+ major health systems including Lifespan Health System and Care New England running CCM programs.
Medicare Billing
CCM billing in Rhode Island.
CCM uses federally standardized CPT codes with uniform reimbursement across Rhode Island. RI 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. RI 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
Rhode Island Medicaid Supplement
RI Medicaid provides partial supplementary coverage — check current RI Medicaid fee schedules for dual-eligible CCM rates.
Regulatory Landscape
CCM compliance in Rhode Island.
Beyond federal Medicare requirements, Rhode Island has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Interstate Licensure
- *Rhode Island is not currently a member of the Interstate Medical Licensure Compact. Providers delivering CCM services must hold a valid Rhode Island medical license.
EHR Integrations
CCM-compatible EHRs.
Major Rhode Island health systems like Lifespan Health System and Care New England use EHR platforms that CCN Health integrates with. Each integration includes automated CCM documentation, billing, and clinical workflows.
PointClickCare
889 integration guides
ALIS
887 integration guides
Ethizo
240 integration guides
athenahealth
240 integration guides
Charm Health
240 integration guides
MatrixCare
240 integration guides
Epic
240 integration guides
August Health
240 integration guides
FAQ
CCM in Rhode Island questions.
Rhode Island's dense healthcare market and 4+ major health systems like Lifespan Health System and Care New England create strong infrastructure for CCM adoption. RI Medicaid offers partial supplementary coverage for dual-eligible patients. High prevalence of heart disease, diabetes, COPD among Rhode Island's patient population drives CCM enrollment.
RI Medicaid provides partial supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. RI Medicaid provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
With 0.2M residents aged 65+, Rhode Island has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in Rhode Island include heart disease with diabetes, and COPD with heart disease. Rhode Island's +10% by 2035 senior population growth means CCM demand is accelerating. Rhode Island's high Medicare Advantage penetration means many seniors are already enrolled in plans that support CCM.
Rhode Island has approximately 0.2M residents aged 65+ (17.6% of the population), with +10% by 2035 projected growth. Dense population with strong healthcare infrastructure. Lifespan and Care New England cover most of the state. High senior population percentage drives demand for remote care.
CCM in Rhode Island must comply with federal Medicare billing requirements and HIPAA. Rhode Island does not currently have a comprehensive state privacy law beyond HIPAA, but standard patient consent and data security requirements apply. Rhode Island is not part of the Interstate Medical Licensure Compact — providers must hold a valid Rhode Island license to deliver CCM services. Rhode Island has telehealth parity. Medicaid managed care covers remote monitoring services.
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 Rhode Island.
Explore other Medicare remote care programs available to Rhode Island 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.