Qualifying Chronic Conditions 2020

Qualifying Chronic Conditions

A list of Qualifying Chronic Conditions for the CCM Program in 2020

Chronic Conditions that Qualify for Chronic Care Management

Patients who are looking to enroll in the Chronic Care Management Program offered by Medicaid must have a minimum of two different chronic conditions to qualify. Below is a list of some of the major qualifying chronic conditions, though there are more conditions that are not listed below. If you are unsure whether your conditions would qualify you for Chronic Care Management program, feel free to contact us at 805-823-0981

For your condition to qualify as a chronic conditions covered by the CCM program, it must:

  • Be a condition that is expected to last at least 12 months, or until the death of the patient
  • Be a condition that puts the patient at a significant risk of death, functional decline, or exacerbation/decompensation

For an official database of all chronic conditions that are possibly applicable, check out the Condition Categories HERE

CCW Chronic Conditions
Acquired HypothyroidismChronic Kidney Disease
Acute Myocardial InfarctionChronic Obstructive Pulmonary Disease
Alzheimer’s DiseaseDepression
Alzheimer’s Disease, Related Disorders, or Senile DementiaDiabetes
AsthmaHeart Failure
Atrial FibrillationHip / Pelvic Fracture
Benign Prostatic HyperplasiaHyperlipidemia
Cancer, ColorectalHypertension
Cancer, EndometrialIschemic Heart Disease
Cancer, BreastOsteoporosis
Cancer, LungRheumatoid Arthritis / Osteoarthritis
Cancer, ProstateStroke / Transient Ischemic Attack


Other Chronic or Potentially Disabling Conditions
ADHD, Conduct Disorders, and Hyperkinetic SyndromePersonality Disorders
Alcohol Use DisordersPost-Traumatic Stress Disorder (PTSD)
Anxiety DisordersPressure and Chronic Ulcers
Autism Spectrum DisordersSchizophrenia
Bipolar DisorderSchizophrenia and Other Psychotic Disorders
Cerebral PalsySensory – Blindness and Visual Impairment
Cystic Fibrosis and Other Metabolic Developmental DisordersSensory – Deafness and Hearing Impairment
Depressive DisordersSickle Cell Disease
Drug Use DisordersSpina Bifida and Other Congenital Anomalies of the Nervous System
EpilepsySpinal Cord Injury
Fibromyalgia, Chronic Pain and FatigueTobacco Use
Human Immunodeficiency Virus and/or Acquired Immunodeficiency Syndrome (HIV/AIDS) *Traumatic Brain Injury and Nonpsychotic Mental Disorders due to Brain Damage
Intellectual Disabilities and Related ConditionsViral Hepatitis (General), including:

Hepatitis A, Hepatitis B (acute or unspecified), Hepatitis B (chronic), Hepatitis C (acute), Hepatitis C (chronic), Hepatitis C (unspecified), Hepatitis D, Hepatitis E

Learning Disabilities
Leukemias and Lymphomas
Liver Disease, Cirrhosis and Other Liver Conditions
Migraine and Chronic Headache
Mobility Impairments
Multiple Sclerosis and Transverse Myelitis
Muscular Dystrophy
Opioid Use Disorder
Other Developmental Delays
Peripheral Vascular Disease (PVD)


Vigilance Health is ready to lead you into the future of Value-Based Healthcare. We're here to provide you with more information, answer any questions you may have, and create an effective solution for your value-based care delivery and reimbursement needs.