Chronic Care Management in Virginia.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, VA Medicaid coverage, and compliance details for Virginia providers.
How does CCM work for providers in Virginia?
Chronic Care Management (CCM) enables Virginia 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 Virginia include heart disease, diabetes, COPD. Medicare covers CCM federally for patients with 2+ chronic conditions. VA Medicaid provides partial supplementary coverage. Serving 1.4M seniors with +22% by 2035 projected growth, Virginia's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 5+ major health systems including Sentara Healthcare and Inova Health System running CCM programs. As an Interstate Medical Licensure Compact member, Virginia facilitates cross-state CCM delivery.
Medicare Billing
CCM billing in Virginia.
CCM uses federally standardized CPT codes with uniform reimbursement across Virginia. VA 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. VA 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
Virginia Medicaid Supplement
VA Medicaid provides partial supplementary coverage — check current VA Medicaid fee schedules for dual-eligible CCM rates. Virginia's telehealth parity law supports remote CCM delivery at equivalent reimbursement rates.
Virginia-Specific Billing Considerations
Virginia Consumer Data Protection Act compliance
Regulatory Landscape
CCM compliance in Virginia.
Beyond federal Medicare requirements, Virginia has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Telehealth Parity
- *Virginia has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits.
- *Virginia has comprehensive telehealth laws. Strong support for chronic care and remote monitoring programs.
Interstate Licensure
- *Virginia is a member of the Interstate Medical Licensure Compact, enabling physicians licensed through the compact to provide CCM services across state lines.
State Privacy Law
- *VCDPA applies to care coordination records and patient communication data stored during CCM activities.
- *Shared care plans must comply with both HIPAA and VCDPA data handling requirements.
Additional Requirements
- *Virginia Consumer Data Protection Act compliance
EHR Integrations
CCM-compatible EHRs.
Major Virginia health systems like Sentara Healthcare and Inova Health System 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 Virginia questions.
Virginia's mix of urban centers and rural communities means CCM serves both high-volume practices affiliated with systems like Sentara Healthcare and Inova Health System and remote clinics where in-person visits are difficult. VA Medicaid offers partial supplementary coverage for dual-eligible patients. Virginia's membership in the Interstate Medical Licensure Compact enables cross-state CCM delivery. High prevalence of heart disease, diabetes, COPD among Virginia's patient population drives CCM enrollment.
VA Medicaid provides partial supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. VA Medicaid provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
Virginia has telehealth parity legislation requiring CCM services to be reimbursed at equivalent rates compared to in-person visits. Virginia is a member of the Interstate Medical Licensure Compact, facilitating cross-state CCM delivery. Virginia has comprehensive telehealth laws. Strong support for chronic care and remote monitoring programs.
With 1.4M residents aged 65+, Virginia has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in Virginia include heart disease with diabetes, and COPD with heart disease. Virginia's +22% by 2035 senior population growth means CCM demand is accelerating.
Virginia has approximately 1.4M residents aged 65+ (15.6% of the population), with +22% by 2035 projected growth. Northern Virginia has dense population near DC. Hampton Roads area has significant senior population. VCDPA creates additional privacy compliance requirements.
CCM in Virginia must comply with federal Medicare billing requirements and HIPAA. Virginia's VCDPA adds state-level data protection requirements for patient health information collected through CCM devices and platforms. As an Interstate Medical Licensure Compact member, Virginia allows compact-licensed physicians to deliver CCM services across state lines. Additional Virginia-specific requirements include: Virginia Consumer Data Protection Act compliance. Virginia has comprehensive telehealth laws. Strong support for chronic care and remote monitoring 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 Virginia.
Explore other Medicare remote care programs available to Virginia 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.