Proposed CCM Copay Change: What H.R. 8261 Could Mean for Medical Practices
A proposed federal bill could remove Medicare patient cost sharing for Chronic Care Management, or CCM. If enacted, the change could make it easier for eligible patients to enroll in and remain engaged with CCM services.
The proposal is called the Chronic Care Management Improvement Act of 2026, H.R. 8261. It was introduced in the U.S. House of Representatives on April 14, 2026. It is not law, and no current Medicare coverage, deductible, or copay requirement has changed.
For independent practices, rural health clinics, cardiology practices, and pulmonology groups, the bill is worth watching because patient cost sharing can affect participation in services delivered between office visits.
What is Chronic Care Management?
Chronic Care Management is a Medicare service designed for patients with two or more chronic conditions expected to last at least 12 months, or until death. These conditions must place the patient at significant risk of worsening health, functional decline, or other serious complications.
CCM supports care that happens outside the traditional office visit. Depending on the patient’s needs and the practice workflow, that may include:
Ongoing care-plan support
Medication coordination
Communication with specialists and other care providers
Patient education and self-management support
Follow-up after changes in health status
Care coordination between scheduled appointments
For patients managing conditions such as heart failure, COPD, diabetes, hypertension, asthma, pulmonary fibrosis, or multiple chronic diseases, CCM can help create more continuity between visits.
What patients pay for CCM today
Under current Medicare rules, CCM is generally subject to normal Part B cost sharing. Medicare typically pays 80 percent of the allowed amount after the deductible, and the patient or their supplemental coverage may be responsible for the remaining amount.
The patient’s actual out-of-pocket cost can vary based on:
The specific CCM service furnished
Medicare coverage status
Whether the Part B deductible has been met
Medigap or other supplemental coverage
Medicare Advantage plan rules
Other payer-specific requirements
Practices should avoid quoting one universal copay amount. Instead, patient-facing conversations should explain that staff can help verify coverage and estimated responsibility before enrollment.
What H.R. 8261 proposes
H.R. 8261 would remove the Medicare Part B deductible and coinsurance requirements for Chronic Care Management services. If the bill passes as introduced, the change would apply to CCM services furnished on or after January 1, 2027.
In practical terms, that could mean eligible Original Medicare beneficiaries would not owe the usual CCM cost share.
However, the proposed change is limited. It would not automatically eliminate cost sharing for every type of remote-care or care-coordination service.
Chronic Care Management - Would remove Medicare deductible and coinsurance if the bill becomes law
Remote Patient Monitoring - No automatic change under this proposed CCM bill
Principal Care Management - No automatic change under this proposed CCM bill
Other Medicare services - No automatic change unless separately addressed by law or policy
The key point for practices: the bill concerns CCM specifically. It should not be presented as a blanket elimination of all remote-care copays.
Why this matters for enrollment
Even modest monthly patient responsibility can create friction at enrollment—particularly when patients do not understand what CCM is, when the service occurs outside of office visits, or when they already have multiple healthcare expenses.
If the bill becomes law, practices may see fewer cost-related questions and fewer enrollment objections for eligible Original Medicare patients. That does not remove the need for clear education, informed consent, eligibility review, and transparent communication.
A strong enrollment conversation should still explain:
What CCM is and why the patient may benefit
What support the patient can expect between visits
Who may contact the patient
How the practice will coordinate with the patient’s care team
Whether the patient has any expected financial responsibility
That benefits and coverage vary by payer and plan
What practices should do now
The bill is still proposed legislation. No immediate billing or enrollment change is required today.
That said, practices can prepare by reviewing their existing CCM workflows:
Confirm current cost-sharing communication. Ensure staff and patient materials accurately explain that current coverage and patient responsibility depend on Medicare and supplemental coverage.
Identify eligible patient populations. Review patients with two or more chronic conditions who may benefit from more consistent support between appointments.
Strengthen enrollment education. Use plain-language materials that clearly explain CCM, patient consent, anticipated outreach, and possible costs.
Build a scalable workflow. Determine who manages outreach, care-plan activities, documentation, coding, claims, and follow-up.
Monitor policy developments. Follow the bill through Congress before changing your financial messaging or patient materials.
How Covalent Care supports CCM
Covalent Care helps practices build and operate remote-care programs for eligible patient populations. Our team can support patient engagement, care-team operations, documentation preparation, coding, claim submission, and revenue-cycle management while the participating practice retains clinical oversight as applicable.
For practices considering CCM alongside RPM, PCM, APCM, or virtual cardiopulmonary rehabilitation, the right model depends on patient needs, payer requirements, clinical appropriateness, and existing workflow.
Frequently asked questions
Has H.R. 8261 passed?
No. H.R. 8261 has been introduced in Congress, but it is not law. Current CCM coverage and cost-sharing rules remain in effect unless and until legislation is enacted.
Would the bill remove every patient copay related to remote care?
No. The proposal is focused on Chronic Care Management. It does not automatically change patient cost sharing for RPM, PCM, or other separate Medicare services.
When could the change take effect?
If enacted as introduced, the bill would apply to CCM services furnished on or after January 1, 2027.
Should practices stop discussing CCM copays now?
No. Practices should continue to communicate current coverage and possible patient responsibility accurately. Do not tell patients that the CCM copay has been eliminated unless and until a change is enacted and applicable.
Can Covalent Care help our practice assess CCM readiness?
Yes. Covalent Care can help a practice assess eligible populations, operational workflows, care-team support, documentation, billing processes, and program fit.
Bottom line
H.R. 8261 is a proposed policy change that could reduce a meaningful enrollment barrier for Chronic Care Management. It is not law today, and practices should not change patient financial communications based on the proposal alone.
However, the bill reinforces an important point: care between visits matters. Practices that have a clear, scalable CCM workflow can be better positioned to support eligible chronic-care patients as reimbursement policy evolves.
Sources and further reading
U.S. Congress, H.R. 8261 — Chronic Care Management Improvement Act of 2026
Centers for Medicare & Medicaid Services — Chronic Care Management Services
[Optional] Mobile Health Providers, “A New Bill Could Eliminate Your 20% Copay for Chronic Care Management”
Use the competitor article only as a “further reading” link if you choose; do not position it as Covalent’s sole source. The primary source should be the official bill record and CMS guidance.
This article is for general informational purposes only and is not legal, billing, coding, or reimbursement advice. Medicare rules, payer policies, and program requirements may change. Practices should consult qualified legal, compliance, coding, and reimbursement professionals regarding their individual circumstances.