Are you interested in elevating your patient care and practice revenue with virtually no additional staff and receiving a monthly payment from CMS averaging $42.60 for each patient enrolled?




Per Patient Cost and Revenue Snapshot

*ROI calculated from average revenue under the CCM billing code 99490 only.
Additional revenue gains will be received from the influx of comprehensive wellness exams.



Leave the details to our CCM team.

As your service aggregators, we are providing the following requirements through Citra staff members acting as an extension of the provider’s office:



  • Oversight of beneficiary self-management medications
  • An electronic version of the care plan as appropriate with other practitioners and providers
  • A written or electronic copy of care plan and document its provision in the EHR
  • Facilitate referrals to other providers
  • Coordinate with home and community-based service providers


Our NURSING STAFF will provide:

  • Systematic assessment of the beneficiary’s medical, functional, and psychosocial needs
  • Perform medication reconciliation with review of adherence and potential interactions
  • Create a patient-centered care plan based on a physical, mental, cognitive, psychosocial, functional and
  • Environmental assessment, and an inventory of resources and support
  • Follow-up after: ER visits, hospital discharge, skilled nursing facility, and other inpatient facilities (Use of care coordination card required)


Our NON-CLINICAL STAFF will provide:

  • Reminders for recommended care services
  • 24/7 access to beneficiary care plan for each provider participating in the CCM Program
  • Assistance with scheduling appointments
You are busy. So here is your short list.


As the Provider, there are just a couple inclusion criteria:

  • Patient information in certified EHR technology
  • 24/7 urgent care with access to the patient’s records (on-call service will suffice)
  • Continuity of care with successive routing appointments


In addition, these are the program requirements:

  • Initiate CCM during an AWV, IPPE, or E/M visit (billed separately from CCM services.)
  • Use the Chronic Conditions Referral form to check the conditions for patient survey
  • Obtain signed Patient Consent Agreement form and upload to certified EHR
  • Document annual receipt of care plan in certified EHR