Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Chronic Care Management?
A primary care doctor most often provides chronic care management, a monthly Medicare service for people with long-term health problems. Other health care providers can offer it too. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Chronic care management is a Medicare service. A doctor or other health care provider helps manage your care for serious long-term health problems, like arthritis or diabetes. It is not a surgery or a test. It is care that continues month after month. Here, the term means the Medicare version.
Medicare says the service includes the following.
- A care plan that lists your health problems and goals, other providers, medicines, and community services you have and need.
- 24/7 access to urgent care needs.
- Support when you go from one health care setting to another.
- Review of your medicines and how you take them.
- Help with other chronic care needs.
Why a doctor might recommend it
To be eligible, you must have 2 or more serious chronic conditions that you expect to last at least a year. Medicare says these conditions put a person at risk of death, a sudden worsening, or a decline in daily life.
Medicare lists conditions that can qualify. They include arthritis, asthma, cancer, depression, diabetes, and hypertension, which is high blood pressure. The list is not complete. Medicare also covers some complex conditions, such as Lyme disease.
How to prepare
To get started, ask your provider if they offer chronic care management services.
- Expect to sign an agreement to get these services every month.
- Expect a first visit if you are new to the provider or have not been seen in a year. It can be a regular visit or an annual wellness visit.
- Know that you need Medicare Part B, the part of Medicare that covers doctor visits.
What happens during it
Your provider prepares a care plan for you or your caregiver. It explains the care you need and how your providers will coordinate it.
Medicare says a care plan may include a problem list, measurable treatment goals, symptom management, medical management, a caregiver assessment, and regular review. It may also include coordination with outside resources and other providers.
Between visits, you can reach your care team for urgent care needs at any hour.
Recovery
Chronic care management is not a one-time procedure, so there is no healing period. The service is provided monthly.
Part B may pay for it. After you meet the Part B deductible, you pay coinsurance, which is your share of the cost. How much you owe depends on other insurance you have, how much your doctor charges, and whether your doctor accepts assignment.
Risks and side effects
Your doctor may recommend services that Medicare does not cover or offers too frequently. That could lead to extra costs for you.
Ask your doctor why a service is recommended and what Medicare will actually cover.
Who performs it
A doctor or other health care provider offers chronic care management. Medicare calls it a primary care service.
Common questions
Who can get chronic care management?
People with Medicare Part B who have 2 or more serious chronic conditions that are expected to last at least a year can get it. Arthritis and diabetes are two examples.
How often is chronic care management provided?
It is provided monthly. Your provider asks you to sign an agreement to get the services on a monthly basis.
Does Medicare pay for chronic care management?
Medicare Part B may pay for it if you are eligible. After the Part B deductible, you pay coinsurance, which is a share of the cost. Ask your doctor how much your care will cost.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can help with the same goals, such as keeping track of your health problems and goals, reviewing your medicines, and coordinating your other providers. Ask any provider if they offer chronic care management services.
Sources
- Medicare.gov - Chronic care management services
- Centers for Medicare & Medicaid Services - Chronic Care Management for Complex Conditions
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
