A monthly charge from your doctor's office, even in months you didn't visit, may be for chronic care management. Medicare.gov says Part B covers it for people with 2 or more serious chronic conditions expected to last at least a year, and your provider must ask you to agree first. After the Part B deductible, you generally pay 20% of the Medicare-approved amount each month.
What is chronic care management?
Medicare.gov says chronic care management includes:
- A care plan listing your health problems, goals, other providers, medicines, and community services.
- 24/7 access for urgent care needs.
- Support when you move from one care setting to another, like from a hospital to home.
- A review of your medicines and how you take them.
- Help with other chronic care needs.
Much of this happens by phone, portal messages, or behind the scenes, so you may be billed in a month without an office visit.
Who can get it?
Medicare.gov says you must have 2 or more serious chronic conditions, like arthritis and diabetes, that are expected to last at least a year.
Related services exist too:
- Principal care management is for one high-risk condition expected to last at least 3 months, like cancer.
- Advanced primary care management is a monthly approach where a primary care practice serves as your main point of care. Medicare.gov says you give verbal or written consent, and it's documented in your record.
Ask your office which one you're getting.
Do I have to agree to it?
Yes. Medicare.gov says your provider will ask you to sign an agreement to get chronic care management on a monthly basis. For advanced primary care management, Medicare.gov says your consent is documented in your medical record.
If you don't remember agreeing, ask the office for a copy of the agreement or the note documenting consent.
What does it cost?
Medicare.gov says that after you meet the Part B deductible, you pay coinsurance, generally 20% of the Medicare-approved amount. CMS lists the 2026 Part B deductible at $283.
So the charge can be small each month, but it adds up over a year. If you have Medigap or other coverage that pays Part B coinsurance, it may cover your share. With Medicare Advantage, your plan's cost sharing applies.
How do I spot it on my bill or notice?
Look on your Medicare Summary Notice or your doctor's bill for:
- A monthly charge from your primary care office or a specialist.
- A description like "chronic care management," "care management," or "principal care management."
- Charges on dates you didn't have a visit.
See how to read your Medicare Summary Notice and what a CPT code is.
What if I didn't agree to it?
Ask the office.
What to say:
"I see a monthly charge for [care management] on [dates]. I don't remember agreeing to this service. Can you send me a copy of my consent? If I didn't agree, please stop the service and correct the charges with Medicare."
If you agreed but want to stop:
"I agreed to chronic care management earlier, but I'd like to stop it starting [month]. Please confirm in writing, and let me know the last month I'll be billed."
Keep a note of the date and who you spoke with.