Resources for care teams
By MySeema
What to confirm before launching a Medicare care-management service
Medicare care-management programs evolve. Clinical need and current service requirements should guide implementation.
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Use the current source
Program names and short summaries are useful starting points. Before a rollout, verify the current eligibility, consent, personnel, documentation, and billing requirements for each service through CMS.
Distinguish the different types of support
Ongoing care management, a transition after discharge, physiological monitoring, therapy monitoring, behavioral-health integration, and navigation for serious illness are different services. Their rules and responsible professionals are not interchangeable.
Build the workflow before the claim
Agree on how a patient enters the service, who provides the work, how concerns reach the clinician, and where the next step is documented. The billing arrangement follows the services actually delivered.
Reviewed September 8, 2026. This page is an implementation overview, not a billing manual or a promise of reimbursement.
Bring your care model. Let’s build the next step.
Discuss the population and workflow you want to support, the responsibilities your team would retain, and the next steps for a proposed scope.