Chronic Care Management in South Carolina.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, Healthy Connections coverage, and compliance details for South Carolina providers.
How does CCM work for providers in South Carolina?
Chronic Care Management (CCM) enables South Carolina 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 South Carolina include diabetes, hypertension, heart disease. Medicare covers CCM federally for patients with 2+ chronic conditions. Healthy Connections provides partial supplementary coverage. Serving 0.9M seniors with +28% by 2035 projected growth, South Carolina's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 5+ major health systems including Prisma Health and MUSC Health running CCM programs.
Medicare Billing
CCM billing in South Carolina.
CCM uses federally standardized CPT codes with uniform reimbursement across South Carolina. Healthy Connections 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. Healthy Connections 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
South Carolina Medicaid Supplement
Healthy Connections provides partial supplementary coverage — check current Healthy Connections fee schedules for dual-eligible CCM rates.
Regulatory Landscape
CCM compliance in South Carolina.
Beyond federal Medicare requirements, South Carolina has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Interstate Licensure
- *South Carolina is not currently a member of the Interstate Medical Licensure Compact. Providers delivering CCM services must hold a valid South Carolina medical license.
EHR Integrations
CCM-compatible EHRs.
Major South Carolina health systems like Prisma Health and MUSC Health 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 South Carolina questions.
South Carolina's mix of urban centers and rural communities means CCM serves both high-volume practices affiliated with systems like Prisma Health and MUSC Health and remote clinics where in-person visits are difficult. Healthy Connections offers partial supplementary coverage for dual-eligible patients. High prevalence of diabetes, hypertension, heart disease among South Carolina's patient population drives CCM enrollment.
Healthy Connections provides partial supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. Healthy Connections provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
With 0.9M residents aged 65+, South Carolina has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in South Carolina include diabetes with hypertension, and heart disease with diabetes. South Carolina's +28% by 2035 senior population growth means CCM demand is accelerating.
South Carolina has approximately 0.9M residents aged 65+ (18.1% of the population), with +28% by 2035 projected growth. Fast-growing retiree population along the coast. Charleston and Greenville have strong healthcare markets. High demand for senior living monitoring in retirement communities.
CCM in South Carolina must comply with federal Medicare billing requirements and HIPAA. South Carolina does not currently have a comprehensive state privacy law beyond HIPAA, but standard patient consent and data security requirements apply. South Carolina is not part of the Interstate Medical Licensure Compact — providers must hold a valid South Carolina license to deliver CCM services. South Carolina has telehealth parity for most services. RPM coverage through Medicaid managed care varies by plan.
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 South Carolina.
Explore other Medicare remote care programs available to South Carolina 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.