Chronic Care Management in Wisconsin.
Non-face-to-face care coordination for patients with multiple chronic conditions. Medicare billing, BadgerCare Plus coverage, and compliance details for Wisconsin providers.
How does CCM work for providers in Wisconsin?
Chronic Care Management (CCM) enables Wisconsin 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 Wisconsin include heart disease, diabetes, COPD. Medicare covers CCM federally for patients with 2+ chronic conditions. BadgerCare Plus provides partial supplementary coverage. Serving 1.0M seniors with +18% by 2035 projected growth, Wisconsin's CCM market is expanding. CCN Health manages clinical workflows, care plan documentation, and monthly billing — integrating with 5+ major health systems including Advocate Aurora Health and Ascension Wisconsin running CCM programs. As an Interstate Medical Licensure Compact member, Wisconsin facilitates cross-state CCM delivery.
Medicare Billing
CCM billing in Wisconsin.
CCM uses federally standardized CPT codes with uniform reimbursement across Wisconsin. BadgerCare Plus 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. BadgerCare Plus 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
Wisconsin Medicaid Supplement
BadgerCare Plus provides partial supplementary coverage — check current BadgerCare Plus fee schedules for dual-eligible CCM rates.
Regulatory Landscape
CCM compliance in Wisconsin.
Beyond federal Medicare requirements, Wisconsin has specific telehealth, licensure, and privacy regulations that affect CCM programs.
Interstate Licensure
- *Wisconsin 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 Wisconsin health systems like Advocate Aurora Health and Ascension Wisconsin 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 Wisconsin questions.
Wisconsin's mix of urban centers and rural communities means CCM serves both high-volume practices affiliated with systems like Advocate Aurora Health and Ascension Wisconsin and remote clinics where in-person visits are difficult. BadgerCare Plus offers partial supplementary coverage for dual-eligible patients. Wisconsin's membership in the Interstate Medical Licensure Compact enables cross-state CCM delivery. High prevalence of heart disease, diabetes, COPD among Wisconsin's patient population drives CCM enrollment.
BadgerCare Plus provides partial supplementary coverage for CCM services. Medicare covers CCM federally for patients with 2+ chronic conditions. BadgerCare Plus provides partial supplementary coverage. For dual-eligible beneficiaries, providers can bill both Medicare and Medicaid to maximize reimbursement.
With 1.0M residents aged 65+, Wisconsin has a large CCM-eligible population — patients with two or more chronic conditions. Common multi-morbidity combinations in Wisconsin include heart disease with diabetes, and COPD with heart disease. Wisconsin's +18% by 2035 senior population growth means CCM demand is accelerating. Wisconsin's high Medicare Advantage penetration means many seniors are already enrolled in plans that support CCM.
Wisconsin has approximately 1.0M residents aged 65+ (17% of the population), with +18% by 2035 projected growth. Strong healthcare systems in Milwaukee and Madison. Marshfield Clinic is a telehealth pioneer. Large rural areas benefit from remote monitoring programs.
CCM in Wisconsin must comply with federal Medicare billing requirements and HIPAA. Wisconsin 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, Wisconsin allows compact-licensed physicians to deliver CCM services across state lines. Wisconsin has telehealth parity with strong support for remote patient monitoring. BadgerCare Plus covers RPM and CCM.
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 Wisconsin.
Explore other Medicare remote care programs available to Wisconsin 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.