Does Medicare cover CCM for Alzheimer's disease?

Yes. Alzheimer's disease and other dementias are qualifying chronic conditions for CCM. There is also a separate Medicare benefit called Cognitive Impairment Care Planning (CICP) that provides a more intensive one-time assessment for beneficiaries with cognitive impairment.

Can I get CCM if I have Medicare Advantage?

Yes. Medicare Advantage plans must cover all Part B services including CCM. Your cost-sharing may differ from Original Medicare, so check your plan's Summary of Benefits.

Is CCM the same as a care management program?

CCM is a specific Medicare billing code for care coordination services. Some providers offer their own care management programs that may or may not be billed under the Medicare CCM code. Ask your provider specifically whether they bill Medicare for CCM services.

Does Medicare cover CCM for Alzheimer's disease?

Yes. Alzheimer's disease and other dementias are qualifying chronic conditions for CCM. There is also a separate Medicare benefit called Cognitive Impairment Care Planning (CICP) that provides a more intensive one-time assessment for beneficiaries with cognitive impairment.

Can I get CCM if I have Medicare Advantage?

Yes. Medicare Advantage plans must cover all Part B services including CCM. Your cost-sharing may differ from Original Medicare, so check your plan's Summary of Benefits.

Is CCM the same as a care management program?

CCM is a specific Medicare billing code for care coordination services. Some providers offer their own care management programs that may or may not be billed under the Medicare CCM code. Ask your provider specifically whether they bill Medicare for CCM services.

Medicare Chronic Care Management (CCM): Coverage, Eligibility & Costs 2026

Medicare Chronic Care Management (CCM) is a Part B benefit that pays for coordinated care services for people with two or more chronic conditions. It covers non-face-to-face services such as care plan development, medication management, and 24/7 access to a care team between regular office visits. For people managing multiple ongoing health conditions, CCM can meaningfully improve care coordination and reduce hospitalizations.

What Is Medicare Chronic Care Management?

CCM is billed by your primary care provider or specialist and involves at least 20 minutes of clinical staff time per month dedicated to your care coordination. Services include creating and maintaining a comprehensive electronic care plan, coordinating referrals and follow-up care, managing medications, and providing 24/7 access to a care team for urgent needs.

Who Qualifies for Medicare CCM?

To qualify for Medicare Chronic Care Management, you must have two or more chronic conditions that are expected to last at least 12 months or until death, and that place you at significant risk of death, acute exacerbation, or functional decline.

Common Qualifying Chronic Conditions for CCM

Condition Category	Examples
Cardiovascular	Heart disease, heart failure, hypertension, atrial fibrillation
Metabolic	Diabetes, obesity, chronic kidney disease
Respiratory	COPD, asthma, sleep apnea
Neurological / Mental Health	Alzheimer's disease, depression, anxiety disorders
Musculoskeletal	Arthritis, osteoporosis
Cancer	Any ongoing cancer diagnosis or treatment

How Much Does Medicare Pay for CCM?

After meeting your Part B deductible ($283 in 2026), Medicare pays 80% of the approved amount for CCM services. You pay the remaining 20% coinsurance. The monthly cost to you is typically around $8 to $12 after Medicare pays its share, making it a very affordable benefit. If you have a Medigap plan, it may cover your 20% share entirely.

One Provider Per Month

You can only receive CCM services from one provider per month. If you have multiple specialists, designate one as your CCM billing provider. Your provider must obtain your written consent before billing Medicare for CCM services.

CCM Under Medicare Advantage

Medicare Advantage (Part C) plans must cover all Medicare Part B services, including Chronic Care Management. Some Medicare Advantage plans offer enhanced CCM benefits or reduced cost-sharing. Check your plan's Evidence of Coverage for specific details.

Who Can Bill for CCM?

The following practitioners can bill Medicare for CCM services: physicians, nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse midwives. The billing provider must be the one primarily managing your chronic conditions.

How to Get Started with CCM

Talk to your primary care provider about whether you qualify. Your provider will document your chronic conditions, create a comprehensive care plan, and obtain your written consent to bill for CCM services. If your provider does not currently offer CCM, ask if they plan to or consider a provider who does.

Medicare Chronic Care Management