Care gaps across your ACO?
ACO care management services
One Care Advocate team across your network. Each practice refers, keeps its care plans and bills its own claims.
- No new hires. We run outreach, consent and monthly calls.
- One file a month. Nothing is billed until you approve it.
- $0 upfront. Works with your EHR, live in about a week.
$66.13* per patient, every month*CPT 99490, 2026 national rate, billed per practice
Get your CCM Plan
Works nationwide
Practices nationwide
You bill under your own NPI
Same Care Advocate every month
RNs, NPs, LCSWs and care companions
Monthly file approved by your team
No new hires needed
One Care AdvocateSame person, every month
Your NPI, your claimYou bill Medicare directly
Monthly billing fileYour team approves it
Care management for ACOs, billed by each participating practice
The ACO or MSO opens the door. The practice decides, refers and bills.
| Who | Participating practice | Companian | ACO or MSO |
|---|---|---|---|
| Agreement | Signs its own services agreement | Works practice by practice | Can introduce practices |
| Patients | Refers eligible Medicare patients from its own panel | Works only from that practice’s list | — |
| Care plan and decisions | Kept by the practice’s own practitioners | Asks the care-plan questions, records answers, routes anything new | — |
| Consent | Keeps it on file | Explains the program and cost-sharing, documents verbal consent | — |
| Monthly file | Approves it before billing | Prepares it for that practice only | — |
| Claim | Bills Medicare Part B under its own NPI and receives the payment | Does not bill Medicare | Not part of the claim |
That split keeps each CMS requirement with its billing practitioner: the initiating visit, care plan, general supervision and claim. So care management for ACOs scales one practice at a time. Our guide to ACO REACH and the LEAD model covers those CMS ACO models separately.
Who calls your network’s patients
Registered nurses, nurse practitioners, licensed clinical social workers and care companions, working remotely by phone and video. Each patient keeps the same Care Advocate. Gloria, our AI assistant, drafts documentation and pre-visit summaries; people make the calls. Anything clinical goes to the practice’s clinicians.
What 500 CCM patients across a network bring in each month
2026 Medicare-allowed amounts, and the diagnosis codes that qualify.
Example panel
$33,065 / month
$396,780 a year · 500 patients × $66.13 (CPT 99490, national)
- CPT 99490 pays $66.13 per patient-month nationally (2026).
- Your locality moves it up or down: $60.71 in Arkansas to $83.76 in Alaska.
- Each extra 20 minutes adds CPT 99439 at $50.44.
| Condition | ICD-10 examples | Program fit |
|---|---|---|
| Hypertension | I10 | CCM with a second condition |
| Type 2 diabetes | E11.9 | CCM with a second condition |
| Heart failure | I50.22 | CCM; PCM alone |
| CKD stage 3 | N18.31 | CCM with a second condition |
Which program fits which practice in your network
Practices choose per patient. These CMS rules decide what can share a month.
| Practice or patient | Program and codes | Rule that matters across a network |
|---|---|---|
| Primary care home, patient with two or more chronic conditions | CCM 99490, 99439, or APCM G0556 to G0558 | The same practitioner cannot bill APCM with CCM or TCM for a patient in a month |
| Specialty practice managing one serious condition | PCM 99424 to 99427 | Condition expected to last at least 3 months; at least 30 minutes in the month |
| Patient seen by two network practices | CCM from one of them | Only one practitioner can bill CCM for a patient per calendar month |
| Serious, high-risk illness that needs navigation | PIN G0023, G0024 | Once per practitioner per month per condition; consent renewed annually |
| Transport, food, housing or another upstream driver blocking treatment | CHI G0019, G0022 | Initiating E/M visit by the billing practitioner; time counted once |
Settle which practice bills CCM for a shared patient before outreach, so the consent call names the right one. See APCM vs CCM for the primary care side.
How a network rolls out, practice by practice
No network-wide launch date. Each practice moves on its own schedule.
The ACO introduces
Your ACO or MSO introduces practices. Each books its own intro call, where Companian’s fee is walked through.
Sign and share
Each practice signs its own agreement, then shares its list by EHR or referral form and approves outreach per patient.
Calls begin
Each patient gets one Care Advocate, who documents verbal consent and works from the referring practice’s care plan.
A file per practice
Each practice’s billing team approves its own monthly file before anything is billed.
What differs between practices in a network
Same codes, different payment and supervision details.
| Code | Service | National 2026 |
|---|---|---|
| 99490 | CCM, first 20 minutes | $66.13 |
| G0557 | APCM level 2 | $53.78 |
| G0019 | CHI, first 60 minutes | $86.17 |
Different localities, different rates
Practices in different counties or states get different rates. Medicare has 109 payment localities; the CCM/PCM revenue calculator shows each one.
For 2026: $33.5675 for qualifying APM participants (QPs), $33.4009 for everyone else. For 99490: about $66.46 versus $66.13, before locality adjustment.
Care management kept its value
The CY 2026 rule (CMS-1832-F) cut work RVUs 2.5% for non-time-based codes. Care management, E/M, behavioral health and telehealth-list codes are exempt.
Supervision stays in the practice
Clinical staff work under the billing practitioner’s general supervision, so supervision sits with each practice, not the ACO. Confirm the arrangement with your counsel.
Consent belongs to the practice
Patients consent to the referring practice’s program, hear about cost-sharing and the one-biller rule, and can stop anytime. The date goes in its file.
Months that block CCM
No CCM in the same period as home health or hospice supervision (G0181, G0182) or monthly ESRD services (90951–90970). Check both before claims. CCM can run during a TCM 30-day period; see transitional care management for those codes.
Questions ACO and MSO leaders ask
Do all our practices have to join?
No. Each practice decides for itself and starts when it is ready. A network can begin with a single practice.
Will this change our attribution, quality scores or shared savings?
We make no claim either way on attribution, quality measures or Medicare Shared Savings Program results. Each practice gets documented time, activities and consent dates monthly.
What can the ACO see?
The monthly file goes to the practice that bills. What a practice shares with its ACO is that practice’s decision under its own agreements and HIPAA.
Do you serve networks with practices in several states?
Yes. Companian works with practices in all 50 states, so every practice in your network can join.
Rates & disclosures
National amounts are 2026 Medicare Physician Fee Schedule non-facility payments at the non-QP conversion factor of $33.4009, computed from CMS RVUs. Your amount depends on your Medicare payment locality; see it in the CCM/PCM revenue calculator. Actual payment depends on participation status, place of service and cost-sharing.
Companian supplies Care Advocates and documentation to physician practices nationwide. Companian is not a medical practice and does not bill Medicare. The billing practitioner keeps the care plan, every clinical decision and the claim. Patients pay the usual Medicare Part B deductible and coinsurance for these services unless other coverage pays it.
Introduce care management across your network
A 15-minute intro on your network and where to start. No patient information needed.