Chronic Care Management
AI-assisted Chronic Care Management for better health outcomes
ColigoMed’s Chronic Care Management (CCM) harnesses sophisticated AI to deliver personalized care for your patients
Our system integrates seamlessly into your workflow, utilizing predictive analytics to monitor patient health continuously. By identifying potential risks early, we reduce hospital readmissions and enhance patient compliance. Our care team staff regularly meet with the patients and will guide them with their medication management, daily routines and any refills or appt scheduling with the practice. The practice is always aware of what is going on with the patient.
A care continuum platform to streamline care coordination and delivery
Manage care for thousands of patients with personalized care plans, symptom analysis, and patient goals using hybrid combination of AI agents and human care team members
Avoid hospitalizations, ER visits with continuous care management
AI voice agents call patients to get latest symptoms, and present key health insights to the care team
Maximize revenue with 90-95% patient coverage

Key Benefits
Real-time predictive patient monitoring
Improved patient engagement and adherence
Reduction in hospital readmissions
Significant operational cost savings
How it works
A practice can generate significant additional monthly revenue by enrolling patients in both Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) programs, based on current Medicare reimbursement rates.
Example Calculation (100 Patients Enrolled):
01
RPM Device Supply & Data Transmission (99454):
$43.02 per patient per month × 100 patients = $4,302
02
RPM Management (First 20 Minutes, 99457):
$47.87 per patient per month × 100 patients = $4,787
03
CCM (Non-Complex, 99490):
$60.49 per patient per month × 100 patients = $6,049
04
Total Monthly Revenue (RPM + CCM):
$4,302 (RPM device) + $4,787 (RPM management) + $6,049 (CCM) = $15,138 per month for 100 patients
Additional Notes:
- One-time RPM setup (99453): $19.73 per patient (not included in monthly total, but adds to initial revenue).
- Additional RPM management time (99458): $38.49 per additional 20 minutes per patient (can further increase revenue if more time is provided).
- Additional CCM time (99439): $45.93 per additional 20 minutes per patient (can further increase revenue).
Summary Table
Service | CPT Code | Rate (per patient/month) | 100 Patients (monthly) |
RPM Device/Data | 99454 | $43.02 | $4,302 |
RPM Management (20min) | 99457 | $47.87 | $4,787 |
CCM (20min) | 99490 | $60.49 | $6,049 |
Total | $15,138 |
Conclusion:
A practice with 100 patients enrolled in both RPM and CCM can expect to generate approximately $15,138 in additional monthly revenue from these programs, before accounting for any additional time or one-time setup fee
FAQ
What is Chronic Care Management (CCM), and who qualifies for it?
Chronic Care Management is a Medicare-supported program designed to help patients with two or more chronic conditions manage their health between doctor visits. Patients with conditions such as diabetes, hypertension, or heart disease typically qualify.
How does AI support the Chronic Care Management process?
ColigoMed’s AI uses predictive analytics and symptom analysis to identify health risks early. AI voice agents also call patients for regular check-ins, providing real-time insights to the care team for timely intervention.
Can this integrate with our existing EHR or workflow?
Yes, ColigoMed’s platform is built to integrate seamlessly with most EHR systems and workflows, enabling practices to deliver better care without additional administrative burden.
What kind of revenue can my practice generate with RPM and CCM?
Practices can earn approximately $15,138 per month with 100 patients enrolled in RPM and CCM services, based on current Medicare reimbursement rates. This does not include potential earnings from additional care time or setup fees.
Is there support provided for onboarding and patient engagement?
Absolutely. Our care team assists with patient onboarding, medication management, appointment scheduling, and ongoing engagement to ensure high compliance and satisfaction.
See what our providers and patients are saying
❝ Our patients and staff truly value the support of the ColigoMed digital health platform. Their paramedical team delivers home-based care with a strong focus on medication adherence, which has noticeably reduced call volume and unnecessary office visits. Over time, we expect to see a real improvement in patient outcomes. With minimal effort from our side, we’re generating consistent, recurring monthly revenue through ColigoMed’s RPM and PCM programs. ❞
❝ We always knew which patients needed the most help. But working with ColigoMed™, we’ve been able to scale our preventative model of care to manage larger populations. ❞
❝ When ColigoMed’s care team started treatment, a huge burden was lifted. They educated us about benefits we weren’t aware of—like meals and transportation. ❞