Most Medicare patients suffer from at least one chronic disease. In fact, between two-thirds and three-quarters of all beneficiaries have been found eligible for chronic care management services. However, the statistics show that a very low number of people access these services. This trend has persisted for quite some time now.
During its initial launch in 2015, only 1.1% of all eligible patients accessed CCM. In 2019, that number increased to 3.4%. The latest figures show that this program benefits around 1.3 million Medicare beneficiaries in 2023. But still the majority of people who could benefit remain outside the program.
These CCM statistics matter for any practice looking at care coordination or remote monitoring. In this guide, we have explained the latest available CCM reimbursement rates 2026 and market trends, including the key figures practices need to understand when reviewing them.
Key Chronic Care Management Statistics for 2026
The underlying data years are shown because the latest available research does not always cover the current calendar year.
| Statistic | Reported figure | Data year |
| U.S. adults with at least one of 12 selected chronic conditions | 76.4% | 2023 |
| U.S. adults with multiple chronic conditions among the same selected conditions | 51.4% | 2023 |
| Adults aged 65 and older with at least one of the selected conditions | 93.0% | 2023 |
| Adults aged 65 and older with multiple selected chronic conditions | 78.8% | 2023 |
| Adults aged 45 and older who had ever had heart disease | 11.3% | 2024 |
| Adults aged 45 and older who had ever had COPD | 7.0% | 2024 |
Sources: CDC Trends in Multiple Chronic Conditions Among U.S. Adults, 2013–2023 and cdc.gov
How Many Americans Have Chronic Conditions?
People living with multiple conditions may need help coordinating appointments, following care plans, managing medications, and keeping different healthcare professionals informed.
CDC data show a high burden of chronic conditions
According to the CDC’s analysis of 2023 Behavioral Risk Factor Surveillance System (BRFSS) data:
- 76.4% of U.S. adults had at least one of 12 selected chronic conditions.
- 51.4% of U.S. adults had two or more of those conditions.
- Among adults aged 65 and older, 93.0% had at least one selected condition, while 78.8% had multiple conditions.
CCM Reimbursement Rates 2026 and Medicare Billing Statistics
Medicare reimbursement for chronic care management has become more attractive in recent years. The billing side of CCM can turn existing effort into a reliable monthly revenue stream for practices already coordinating care between visits.
When reviewing CCM Reimbursement Rates 2026, practices should consider both the Medicare payment amounts and the work required to meet the applicable billing requirements.
Here are the approximate national average non-facility rates for the main CCM codes under the 2026 Medicare Physician Fee Schedule. Actual payment varies by geographic locality and whether the practice participates in an Advanced Alternative Payment Model.
| CPT code | Service | General time requirement |
| 99490 | Non-complex CCM performed by clinical staff | First 20 minutes per calendar month |
| 99439 | Add-on for additional non-complex CCM time by clinical staff | Each additional 20 minutes |
| 99491 | Non-complex CCM personally performed by a physician or other qualified healthcare professional | First 30 minutes per calendar month |
| 99437 | Add-on for additional practitioner-performed CCM time | Each additional 30 minutes |
| 99487 | Complex CCM performed by clinical staff | First 60 minutes per calendar month |
| 99489 | Add-on for additional complex CCM time by clinical staff | Each additional 30 minutes |
A common non-complex patient that gets 40 minutes of clinical staff time within one month can make revenues of around $116. This number increases to $166 for 60 minutes of care. Complex patients that qualify for a higher threshold for medical decision-making can begin at $144, with further potential increases for extra time.
Data from the claims demonstrate steady growth. The basic code 99490 grew from 4.6 million services in 2022 to 5.7 million in 2023. Total CCM claims across codes reached approximately 6.5 million that year. It’s averaging a little more than five claims per enrolled beneficiary.
Understanding the individual codes is an important part of evaluating CCM Reimbursement Rates 2026, because different codes have different time and service requirements.
Barriers to CCM Adoption: What the Data Shows
Chronic care management has clear clinical and financial upside. But a large share of eligible Medicare patients still do not receive it. The gap is rarely about patient need. The real obstacles tend to sit inside the practice.
Here is what the data and real-world experience consistently point to:
- Time tracking and documentation requirements remain the biggest practical hurdle
- Staffing constraints limit scale
- Patient engagement drops after the first few months
- Billing and compliance uncertainty slows participation
- Eligibility is high, but identification and consent are inconsistent
- Geographic and practice-size variation is noticeable
These barriers explain why utilization remains far below the eligible population even after a decade of Medicare payment. The good news is that most of the obstacles are operational rather than clinical. Practices can solve these challenges and convert eligibility into sustained monthly coordination and consistent reimbursement.
CCM Market Size and Growth Trends (2026 and Beyond)
The chronic care management market continues to expand as more practices recognize both the clinical value and the revenue potential of structured between-visit support. The exact figures vary by research firm depending on whether they measure services or the full care coordination ecosystem. But the overall direction is clear.
Current Market Size
One recent estimate puts the global market at roughly $6.3 billion in 2025, rising to about $7.1 billion in 2026. Other reports that focus more heavily on software and digital platforms report higher figures. North America remains the largest regional market due to Medicare’s established CCM payment structure and the high volume of eligible beneficiaries.
These market figures provide broader context for CCM Reimbursement Rates 2026, although market-size estimates should not be confused with Medicare reimbursement amounts.
Projected Growth Through 2031
Most forecasts point to solid expansion looking ahead. One widely cited projection expects the market to reach approximately $13 billion by 2031. This reflects a compound annual growth rate near 13% from 2026 onward. Growth is expected to come from several directions at once:
- Continued increases in the number of Medicare beneficiaries with multiple chronic conditions
- Wider use of cloud-based care management platforms
- Greater willingness among primary care practices to outsource or systematize the administrative side of CCM
Common Challenges in Running a CCM Program
CCM requires ongoing work outside face-to-face appointments. Without clear processes, these responsibilities can compete with a practice’s other demands.
Patient identification and enrollment
Staff must identify potentially eligible patients, confirm requirements, explain the service, and document consent. Inconsistent enrollment workflows can make it harder to establish and maintain a program.
Monthly patient outreach
Patients need regular contact and care coordination appropriate to their needs. Missed calls, outdated contact details, and difficulty reaching patients can disrupt follow-up.
Time tracking and documentation
Incomplete notes or unreliable time tracking can create billing and audit risks. For this reason, understanding CCM Reimbursement Rates 2026 is only one part of running a compliant program.
Staffing and workload
Monthly calls, patient updates, care coordination, and documentation require staff time. Practices need to decide which tasks their own team will perform and which tasks can be supported by an outside service.
Technology and workflow integration
CCM records must fit into the practice’s existing processes. Poorly coordinated systems can lead to duplicate work, missed updates, or difficulty finding the information needed for follow-up.
Billing and compliance
Practices must use the correct codes, meet time and service requirements, and follow applicable consent, care plan, supervision, and documentation rules. Billing processes should be reviewed regularly rather than relying on assumptions about what qualifies for payment.
When practices review CCM Reimbursement Rates 2026, they should also review the requirements associated with each applicable code rather than focusing only on the dollar amount.
How Technology Can Support CCM Workflows
With the help of technology, practices can organize patients’ valuable information and track activity.
Patient engagement and follow-up tools
Scheduling and outreach tools can help staff plan monthly contacts, record unsuccessful attempts, and identify patients who need follow-up.
Documentation and time tracking
Structured records can help teams document patient interactions and track qualifying time. Staff must still ensure that records accurately reflect the work performed.
Integration with remote patient monitoring
When both programs are used, practices need clear workflows for reviewing information, routing concerns to the clinical team, documenting services, and meeting the separate billing requirements for each program.
AI and workflow automation
In this modern era, there are so many administrative tasks that can be done with the help of AI, like identifying missing documentation or follow-up. Human analysis is always there; it can not be replaced. The final decision should be the responsibility of healthcare professionals.
How MediRemote Supports Chronic Care Management Programs
MediRemote partners with healthcare practices that require operational support for Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and Principal Care Management (PCM). We provide assistance rather than requiring clinic staff to be involved in all the program task logistics.
Patient Onboarding and Enrollment Assistance
Patients have to be provided with specific instructions before being able to take part in a care management program.
MediRemote assists in providing patient onboarding and setup calls. It might reduce the workload that clinic staff will have regarding routine program onboarding.
Patient Communications
MediRemote provides assistance with patient communications and reminders that can help to keep the practice’s program workflows running smoothly. For CCM, it involves making monthly patient calls as well as coordination-related actions in the program as per the agreed service model.
Device Logistics, Setup, Readings Review
For RPM programs, MediRemote offers assistance with device logistics, patient setup, and readings review. This helps in organizing information that comes to the clinical team. This does not involve a clinician’s assessment, but it is important for practices to set up a protocol for urgent readings and patient emergencies.
Documentation, Time Tracking
CCM programs require documentation of services performed.
MediRemote describes time-tracking and documentation assistance as part of its operations service. These services help practices to organize program activity and review records for billing purposes.
Practices have to make sure about the extent of documentation, reporting, and billing assistance that will be provided by MediRemote and independently check payer requirements.
Conclusion
The numbers around CCM reimbursement rates 2026 tell a consistent story. A large share of Medicare patients qualify for the service, the clinical results are solid, and reimbursement has become more workable.
For practices planning their 2026 care-management strategy, CCM Reimbursement Rates 2026 can help provide a starting point for understanding the potential financial side of the program. However, reimbursement depends on meeting the applicable Medicare requirements and accurately documenting the services provided.
That is where MediRemote can help. Its CCM support model assists practices with everything from checking patient eligibility to coordinating enrollment and monthly outreach to managing documentation and time tracking.
Frequently Asked Questions
What does CCM stand for in healthcare?
CCM stands for Chronic Care Management. It’s a Medicare program that pays providers for the non-face-to-face work of coordinating care for patients who have two or more chronic conditions.
How many Medicare enrollees qualify for CCM?
About 66%-75% of all Medicare beneficiaries qualify based on clinical criteria. This indicates that many primary care providers already have enough eligible patients for the program.
How many patients utilized CCM services in the past few years?
About 1.3 million Medicare patients availed the benefits of CCM in 2023. Enrollment has expanded steadily.
How much does Medicare pay for CCM in 2026?
Practices should check the CMS Physician Fee Schedule before calculating projected revenue.The applicable CCM Reimbursement Rates 2026 can vary based on the specific billing code, geographic locality, and other payment factors.
How many providers are currently billing for CCM?
CMS designed CCM codes to support over 180,000 primary care physicians nationwide who care for Medicare fee-for-service beneficiaries.
Are CCM Reimbursement Rates 2026 the same for every practice?
Medicare payment can vary based on factors such as geographic locality and applicable payment adjustments.