IMPLEMENTATION · CARE MANAGEMENT PROGRAMS

Care Management, Run In House

We help medical practices build chronic care management and remote monitoring programs staffed by their own team, from program selection through the first billing cycles and into ongoing support.

Medicare pays monthly for structured care management: chronic care management (CCM), principal care management (PCM), remote physiologic monitoring (RPM), remote therapeutic monitoring (RTM), and the newer advanced primary care management (APCM) bundle. Many practices either never build these programs or hand them to an outsourced vendor whose staff have never met their patients. We implement the third option: your program, run by your people, on the platform you choose. If you are weighing that choice now, our guide to evaluating chronic care management companies covers how they price it, where the audit exposure sits, and what to ask before you sign. Before enrolling anyone, it is worth confirming which conditions qualify for chronic care management, because Medicare applies a two-part test rather than a list of diagnoses. When the workflow itself is what you are building, our step by step guide to how to bill for chronic care management walks through consent, the initiating visit, time capture, and the date of service choice on the claim.

The timing matters. CMS has proposed that beginning January 1, 2027, RPM and RTM may only be billed when furnished by clinical staff directly employed by the billing practice. If that rule is finalized as written, third party staffing for those two service lines ends. CCM and PCM are not part of the proposed staffing change and would be unaffected. Practices that run remote monitoring through a vendor will need their own staffing model. Our care coordinator job description guide covers how to write that role so the time you pay for is time you can bill. Practices starting fresh can build it correctly the first time.

Run an orthopedic, pain, or joint practice? See how these programs fit a musculoskeletal patient panel.

Run a cardiology practice? See how these programs fit a cardiology patient panel.

What we implement

• Program selection and eligibility analysis for your patient panel
• A staffing model and hiring plan for your own care coordinators
• Platform selection and configuration, vendor neutral, on the tools you choose
• Workflows, documentation standards, and written procedures
• Consent, initiating visit, supervision, and time tracking mechanics
• An enrollment playbook and staff training for your first enrollment cohort
• Quality checks on your first billing cycles, then ongoing support

What we do not do

We do not submit claims and we do not run your revenue cycle. Your practice or your existing biller keeps billing, and we advise on the billing mechanics of these programs as consultants. Our pricing follows the same principle: every engagement is a flat fee set in advance, and nothing we charge depends on how many patients enroll or what your claims pay.

We built one ourselves

The playbooks we install come from a program we designed, implemented, and still support. At our founder’s clinic we built the remote therapeutic monitoring and principal care management program: the workflows, the documentation standards, the time tracking, the billing mechanics. The clinic’s own staff runs it day to day, which is exactly the model this service builds for you. That implementation experience is why the work gets concrete, down to the consent language, the time logs, and the monthly close checklist. This service extends the same in house model across CCM, APCM, and RPM.

How it works

1. An optional, fixed fee assessment: a written recommendation on which programs fit and what staffing they need, with no obligation to go further. Or skip it and go straight to building.
2. We design and build the program.
3. We train your own team to run it.
4. Launch, then ongoing support.

This is not for you if

We would rather say so early than take on an engagement that will not work. This service is probably not the right fit if:

• You want an outside company to staff and run the program for you. This model puts your own team on the work; we design it, build it, and support it.
• No one on your team can be given protected, set aside hours to run it. These programs need a named coordinator whose care management time is not the first thing dropped on a busy day.
• Only a small share of your patients have ongoing chronic conditions, or your visits are mostly one time, acute, or surgical. Care management is built for patients you follow over months and years.
• You want someone to take over your billing and submit your claims. Your practice or your biller keeps billing; we advise on the mechanics but never operate your revenue cycle.
• You are looking for a guaranteed monthly revenue number. We can model the math on your own panel and show you the honest range, but we do not promise a figure.

If several of these describe your practice today, the timing may simply be early. The 2027 transition checklist and the code guides below are free to use whenever you are ready.

Guides

Plain language references we maintain as the rules move: the CY 2027 proposed staffing rule, the 2027 RPM and RTM transition checklist, the in house vs vendor revenue calculator, and the code guides: CPT 99490, CPT 99439, complex CCM 99487 and 99489, physician time CCM 99491 and 99437, APCM G0556 through G0558, PCM 99424 through 99427, the RPM code set, and the RTM code set.