Chronic Care Management in West Virginia.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, WV Medicaid coverage, and compliance details for West Virginia providers.
How does CCM work for providers in West Virginia?
Chronic Care Management (CCM) enables West 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 West Virginia include heart disease, diabetes, COPD. Medicare covers CCM federally for patients with 2+ chronic conditions. WV Medicaid provides partial supplementary coverage. Serving 0.4M seniors with +8% by 2035 projected growth, West Virginia's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 5+ major health systems including WVU Medicine and CAMC Health System running CCM programs. As an Interstate Medical Licensure Compact member, West Virginia facilitates cross-state CCM delivery.
Medicare Billing
CCM billing in West Virginia.
CCM uses federally standardized CPT codes with uniform reimbursement across West Virginia. WV 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. WV 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
West Virginia Medicaid Supplement
WV Medicaid provides partial supplementary coverage — check current WV Medicaid fee schedules for dual-eligible CCM rates.
Regulatory Landscape
CCM compliance in West Virginia.
Beyond federal Medicare requirements, West Virginia has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Interstate Licensure
- *West Virginia 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 West Virginia health systems like WVU Medicine and CAMC Health System 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 West Virginia questions.
As a predominantly rural state, West Virginia providers particularly benefit from CCM's remote care capabilities, reducing the need for patients to travel long distances. WV Medicaid offers partial supplementary coverage for dual-eligible patients. West Virginia's membership in the Interstate Medical Licensure Compact enables cross-state CCM delivery. High prevalence of heart disease, diabetes, COPD among West Virginia's patient population drives CCM enrollment.
WV Medicaid provides partial supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. WV Medicaid provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
With 0.4M residents aged 65+, West Virginia has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in West Virginia include heart disease with diabetes, and COPD with heart disease. West Virginia's +8% by 2035 senior population growth means CCM demand is accelerating. West Virginia's lower Medicare Advantage penetration means most seniors are on original Medicare, which fully covers CCM under fee-for-service billing.
West Virginia has approximately 0.4M residents aged 65+ (21.3% of the population), with +8% by 2035 projected growth. Highest median age in the US. Extreme chronic disease burden and rural geography make remote monitoring critical. Appalachian communities face significant healthcare access challenges.
CCM in West Virginia must comply with federal Medicare billing requirements and HIPAA. West Virginia 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, West Virginia allows compact-licensed physicians to deliver CCM services across state lines. West Virginia has telehealth parity. Expanded Medicaid provides comprehensive RPM and CCM coverage.
West Virginia Regulatory Sources
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 West Virginia.
Explore other Medicare remote care programs available to West 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.