Chronic Care Management: The Patient Agreement

Securing a patient’s informed and written consent is an important part of the Medicare Chronic Care Management (CCM) Services program. Medicare requires it of physicians who bill for CCM services because, for one thing, patients are responsible for cost-sharing they are not used to (supplemental insurance may cover the extra costs for some patients). Plus, you’ll want your patients to understand why it’s worth their while — not just yours — to pay for CCM services.

Once you’ve identified Medicare patients who are eligible for the CCM program, you could send a letter outlining what the program entails. However, Medicare requires that you obtain the patient’s informed and written consent during a face-to-face visit, such as during an initial preventive physician exam, annual wellness visit, or comprehensive evaluation and management visit billed separately. During this visit, you can discuss the program more fully. In the patient’s medical record, document this discussion and note the patient’s decision to accept or decline the service.


  • What CCM is and what services are involved, and 
  • How to access elements of their CCM service. 

Also explain these items, which the written consent agreement must spell out, as well: 

  • How members of the care team will share information with the patients’ authorization in the agreement,
  • How cost sharing applies to CCM services,
  • How to revoke services, and
  • That only one practitioner may furnish and be paid for CCM services per calendar month. 

You need to obtain informed patient consent only once prior to furnishing the CCM service. However, if the patient chooses to change the practitioner who will furnish and bill the service, a new agreement is in order.

Learn More

TMA staff will cover the Medicare Chronic Care Management Services program during TMA’s annual Medicare seminar, which runs Nov. 3-Dec. 3 in cities around the state. Register now to also learn about the new Medicare Access and CHIP Reauthorization Act of 2015, the impact of the Sustainable Growth Rate formula’s repeal, and what’s up with meaningful use and the Physician Quality Reporting System. Plus you’ll get some nuts-and-bolts updates about current Medicare payment and enrollment.

Published Oct. 27, 2015

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Last Updated On

November 22, 2019

Originally Published On

October 27, 2015

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