Utilization of Medicare Care Management Codes

Beginning in 2013, the Centers for Medicare & Medicaid Services (CMS) developed care management codes to support and reimburse health care providers for services that help manage chronic conditions and coordinate patient care. These codes reflect Medicare's broader strategy to promote value-based care by compensating providers not only for direct clinical services but also for the essential care coordination activities that contribute to better health outcomes. The number and scope of care management services have evolved over time, with new codes being added as recently as 2024.

This quantitative, descriptive study will answer the following research questions:

1. To what extent are providers serving rural areas billing for Medicare care management codes?
2. To what extent are Medicare beneficiaries in rural areas accessing care management services?

These findings will describe the uptake of the Medicare care management billing codes among rural and urban providers since January 2024. We will examine both overall and monthly trends in the number of claims and in the number of providers billing for care management services, broken down by provider type, region, and rurality. Findings will inform strategies to enhance rural participation in care management and support value-based care readiness.