A dedicated care team becomes an extension of your practice: monthly clinical touchpoints, personalized care plans, medication reconciliation, and a 24/7 access line — with every minute time-tracked to CMS requirements.
Chronic Care Management is a Medicare-covered service for patients with two or more chronic conditions expected to last at least 12 months, or until the patient's death, and that place the patient at significant risk of death, acute exacerbation, or functional decline. It pays for the coordination work that happens between office visits — the phone calls, medication checks, and care-plan updates that keep a patient stable.
Most practices know this revenue exists and don't capture it, because running CCM well takes a dedicated team: someone has to identify eligible patients, get consent, call them every month without fail, document every minute against CMS rules, and keep the whole thing audit-ready. That operational lift is the reason Elixir exists.
| Code | Description |
|---|---|
| 99490 | 20 min clinical staff time, first 20 min/month |
| 99439 | Each additional 20 min (up to 2x) |
| 99487 | Complex CCM, 60 min, moderate/high complexity |
| 99489 | Complex CCM, each additional 30 min |
Bring your panel size and payer mix to a 60-minute opportunity session and leave with a specific, numbers-based program design.