By Gautamdev Chowdary, co-founder and CTO, Zynix AI · Updated November 6, 2026
Disclosure: Zynix AI makes one of the platforms in this guide. Every description of another vendor comes from that vendor’s own website as of November 6, 2026, linked in the source notes. This is not a ranking: products change, so confirm current capabilities with each vendor.
Key takeaways
Chronic care management (CCM) software helps a practice find eligible Medicare patients, record consent, build care plans, log care time and bill CCM codes such as 99490 and 99439. Options split three ways: software your own staff run, outsourced services whose nurses make the calls, and vendors that offer both.
- Decide first who will make the calls: your staff, a vendor’s nurses, or a mix. That choice narrows the field more than any feature list.
- Software-first options include ThoroughCare and ChronicCareIQ; HealthArc, Prevounce, TimeDoc Health and Vivo Care offer software or managed services; ChartSpan and Signallamp Health (now Tellihealth) are service-led.
- If you also need transitional care management (TCM), check that the vendor names it: not every CCM vendor supports TCM workflows.
- Zynix AI runs CCM check-ins and TCM outreach as care plans inside a value-based care platform, with clinical questions routed to your clinicians and CCM time reviewed by the billing provider.
What does CCM software do?
CCM software runs the monthly work Medicare pays for under chronic care management. CMS describes CCM as care management for patients with two or more chronic conditions expected to last at least 12 months that place them at significant risk, with patient consent and a comprehensive care plan. CPT 99490 covers the first 20 minutes of clinical staff time in a calendar month, and 99439 each additional 20 minutes.
Good CCM software covers the whole loop: eligibility lists, consent capture, care plans, outreach, time tracking by staff type, documentation the billing practitioner can review, and claims or a billing export. For the full billing rules, see our guide to CCM billing requirements for 99490, 99439 and 99487.
Software, outsourced service or both?
The biggest difference between CCM vendors is who does the work. Each model fits a different practice:
- Software your staff run. Your nurses and medical assistants make the calls and document in the vendor’s platform. You keep the relationship and the margin, and you need the staff.
- Outsourced service. The vendor’s nurses call your patients, usually under general supervision, and the practice bills. It is fast to start; ask how revenue is shared and how clinical questions reach your clinicians.
- Both. Several vendors let you start with their care team and move work in-house later, or split programs between the two.
CCM software and services at a glance
Each row summarizes the vendor’s own description as of November 6, 2026. “Model” is how the vendor describes who does the work. The last column is our reading of who each may suit, not a ranking.
| Vendor | Model | Programs the vendor names | May suit |
|---|---|---|---|
| ThoroughCare | Software | CCM, PCM, BHI, CoCM, RPM, TCM, APCM, AWV | Practices and care coordination teams that run several Medicare programs in-house. |
| ChronicCareIQ | Software | CCM, RPM, RTM, PCM, BHI/CoCM, TCM, APCM, CPM | High-volume Medicare practices and specialty groups consolidating programs and billing. |
| HealthArc | Software, co-managed or fully managed | RPM, CCM, RTM, TCM, PCM, BHI, APCM, MTM, PIN | Practices, health systems and ACOs that want one platform with the option of HealthArc’s clinical team. |
| Prevounce | In-house, hybrid or fully outsourced | RPM, CCM, APCM, AWV and preventive services | Practices that want CCM with RPM devices and the choice of Prevounce care managers. |
| TimeDoc Health | Software, services or both | CCM, RPM, BHI, APCM, AWV | Health systems, medical groups and community health centers that want EHR-integrated CCM with optional staffing. |
| Vivo Care | Software only or Vivo Care care navigators | RPM, CCM, PCM, APCM | Physician groups, FQHCs and ACOs that want CCM and RPM with US-licensed navigators available. |
| ChartSpan | Full-service program | CCM, APCM, AWV, RPM enrollment | Primary care, specialty practices, RHCs and FQHCs that want a fully managed CCM program. |
| Signallamp Health (now Tellihealth, signalCCM) | Outsourced nurses | CCM, TCM, RPM | Health systems and physician groups that want vendor nurses working inside their own EHR. |
| Lightbeam TCM, CCM & Rising Risk Management | Platform within a population health suite | TCM, CCM, rising-risk management, device-free RPM | ACOs and MSOs that want care programs inside a population health platform. |
| Zynix AI | Platform with AI agents; your clinicians decide | CCM check-ins, TCM outreach, AWV and gap-closure care plans | ACOs, MSOs, independent practices and FQHCs that want CCM and TCM follow-up run across practices on different EHRs. |
The vendors, one by one
ThoroughCare
ThoroughCare calls itself “an end-to-end solution for Chronic Care Management.” It lists care plans with SMART goals and evidence-based assessments, worklists filtered by care manager, status, billable CCM time and risk, task assignment, SDOH assessments, automatic assignment of CCM CPT codes (99490, 99439, 99487, 99489, 99491, 99437 and G0511) and secure texting. Its home page lists CCM, collaborative care, RPM, APCM, BHI, PCM, TCM and annual wellness visits, and its TC Compass assistant adds AI-generated summaries and care plan goals.
ChronicCareIQ
ChronicCareIQ says it “supports CCM, RPM, RTM, PCM, BHI/CoCM, TCM, APCM, and CPM in one platform.” Its modules cover risk dashboards (RiskIQ), patient tracking (PatientIQ), billing-code calculation with audit-ready documentation (BillingIQ) and automatic capture of phone-based care time from 50+ phone systems (CallerIQ). It positions itself as chronic care management software for high-volume Medicare practices.
HealthArc
HealthArc offers software-only, co-managed and fully managed models: “Run programs with your own staff, or hand day-to-day monitoring to HealthArc’s pod-based clinical teams.” For CCM it lists eligibility filters, electronic consent, condition-specific care plan templates, automated time tracking and billing exports mapped to 99490, 99439, 99487 or 99491. It names nine CMS programs, including TCM and APCM, and lists physician practices, health systems and ACOs among the organizations it serves.
Prevounce
Prevounce describes “guided workflows for care plan creation, time tracking, patient engagement, billing, and available managed services.” Its CCM software flags eligible patients and easily missed steps such as informed consent, offers editable care plan templates and produces a single billing report. Its care management services run in-house, hybrid or fully outsourced, with claims submitted by the practice in each model. In June 2025 it launched AI Insights, which summarizes RPM readings and CCM and APCM notes.
TimeDoc Health
TimeDoc Health, founded in Chicago in 2015, lets practices use its CCM software alone or add its care coordination services. It lists enrollment and consent services, physician-created or custom care plan templates, documentation from inside the patient chart through EHR integration, and a panel prioritized by risk, minutes documented and active problems. Its programs include CCM, RPM, BHI, APCM and annual wellness visits.
Vivo Care
Vivo Care, where the optimize.health domain now redirects, says practices can “choose software only or let our U.S.-licensed care navigators manage patient engagement, documentation, and billing compliance on your behalf.” It lists consent capture, individual care plans, automatic time tracking, billing functionality and data sent to the EHR, with point-of-care enrollment on athenahealth and eClinicalWorks. Its programs are RPM, CCM, PCM and APCM, and it lists physician practices, FQHCs and ACOs among its customers.
ChartSpan
ChartSpan is a service, not software for your staff: asked whether it is CCM software, it answers “No, we’re a full-service program with a highly-trained team of clinicians and nurses who work with patients.” It identifies eligible patients for the practice to approve, enrolls them, documents care plans that are shared through the EHR, and its RapidBill tool lets the practice review and bill under general supervision. It runs CCM, APCM and annual wellness visit programs, and in June 2026 it added Validic’s remote monitoring software through an acquisition.
Signallamp Health (now Tellihealth)
Signallamp Health says it is now Tellihealth, with its CCM service continuing as signalCCM. It employs its own home-based RNs and LPNs, who work in the practice’s own EHR; it uses existing CMS billing codes and shares in the revenue from the services its nurses deliver. Its services cover CCM, RPM and TCM; for TCM, its nurses make the first contact with discharged patients and manage follow-up.
Lightbeam
Lightbeam offers TCM, CCM and rising-risk management inside its population health platform, combining AI-enabled risk prediction with automated patient engagement, configurable alerts and device-free remote monitoring. It suits ACOs and MSOs that want care programs alongside contract analytics; see our care management software comparison for the wider platforms.
Zynix AI
Zynix AI runs CCM and TCM as care plans inside the AI operating layer for value-based healthcare. For CCM check-ins, voice and text agents contact enrolled patients each month, route clinical questions to the practice and leave CCM time for the billing provider to review. For TCM, hospital ADT notifications trigger outreach to attributed patients, licensed clinical staff make the TCM interactive contact inside the two-business-day window, and follow-up visits are booked with primary care.
Agents never diagnose, triage symptoms or recommend treatment; they route symptom questions to your on-call clinician by rule. Zynix connects to 30+ EHR systems across 300+ connected instances, so one program can run across practices on different EHRs.
What about TCM and RPM?
TCM follows a discharge: CMS requires an interactive contact with the patient within two business days of discharge and a face-to-face visit within 7 days (99496, high complexity) or 14 days (99495, moderate complexity). Vendors that name TCM include ThoroughCare, ChronicCareIQ, HealthArc, Signallamp Health, Lightbeam and Zynix AI; for TCM, ask how discharges are detected, since ADT feeds are what make the two-day window workable. See TCM billing: 99495 vs 99496 for the rules.
Remote patient monitoring is a separate program with its own codes. Some vendors lead with it: CareSimple, for example, focuses on device-based RPM and tracks CCM time alongside it. If RPM is your main program, compare RPM vendors directly.
How to choose CCM software
- You have care managers and want to keep the work in-house: compare software-first platforms such as ThoroughCare and ChronicCareIQ, or the software tiers of HealthArc, Prevounce, TimeDoc Health and Vivo Care.
- You have no staff for monthly calls: compare service models (ChartSpan, Signallamp Health) and managed tiers, and read the revenue-share terms closely.
- You run CCM and TCM across an ACO or MSO on several EHRs: look at platforms built for networks, such as Lightbeam or Zynix AI, and check how each handles ADT feeds and attribution.
Whichever you choose, check consent capture, time tracking by staff type, how documentation reaches the billing practitioner, and how symptom questions reach a clinician.
Frequently asked questions
What is the best chronic care management software?
There is no single best option; the right one depends on who will do the monthly work. Practices with their own care managers usually compare software-first platforms such as ThoroughCare and ChronicCareIQ. Practices without staff look at service models such as ChartSpan, or vendors that offer both, such as HealthArc, Prevounce, TimeDoc Health and Vivo Care. Networks running CCM and TCM across EHRs look at platforms such as Lightbeam or Zynix AI.
Is CCM software the same as an outsourced CCM service?
No. With software, your own clinical staff make the calls and document in the vendor’s platform, and you keep the revenue after the subscription. With an outsourced service, the vendor’s nurses do the calls, usually under general supervision, and the vendor shares the revenue. Many vendors now offer both and let you mix them by program or move work in-house over time.
Which codes should CCM software support?
At minimum CPT 99490 and 99439 for clinical staff CCM, 99487 and 99489 for complex CCM, and 99491 and 99437 for practitioner CCM, plus G0511 if you are an FQHC or RHC. Practices that also run principal care management, TCM, behavioral health integration or advanced primary care management (G0556 to G0558) should check those programs by name, since vendors differ.
Does CCM software integrate with my EHR?
Most vendors integrate with major EHRs, but depth varies: some read demographics and problems only, some push PDFs or charges back, and some service vendors work directly inside your EHR. Ask which data flows each way for your EHR version, where the care plan lives, and who maintains the interface.
Can AI agents make CCM calls?
AI voice and text agents can handle routine CCM check-ins, reminders and scheduling within scripts your team approves, and some vendors use AI to summarize notes or flag at-risk patients. Clinical judgment stays with licensed staff: ask how symptom questions are routed to a clinician and how agent conversations are documented for the billing practitioner’s review.
Related reading
- CCM Billing Requirements 2026: CPT 99490, 99439, 99487, 99489 and 99491 Explained
- TCM Billing: CPT 99495 vs 99496 Requirements, Timelines and Documentation
- Care Management Software for ACOs and Physician Groups: 9 Platforms Compared (2026)
Source notes
Centers for Medicare & Medicaid Services: Chronic Care Management Services (MLN909188). https://www.cms.gov/files/document/chroniccaremanagement.pdf
Centers for Medicare & Medicaid Services: Transitional Care Management Services (MLN908628). https://www.cms.gov/files/document/mln908628-transitional-care-management-services.pdf
ThoroughCare: Chronic Care Management Software. https://www.thoroughcare.net/chronic-care-management-software
ThoroughCare: Home page. https://www.thoroughcare.net/
ChronicCareIQ: The ChronicCareIQ platform. https://www.chroniccareiq.com/product/cciq/
HealthArc: Chronic Care Management. https://www.healtharc.io/chronic-care-management/
HealthArc: Home page. https://www.healtharc.io/
Prevounce: Chronic Care Management Software. https://www.prevounce.com/software/chronic-care-management
Prevounce: Care management services. https://www.prevounce.com/services/care-management
TimeDoc Health: Chronic Care Management. https://timedochealth.com/chronic-care-management/
Vivo Care: CCM Made Simple. https://vivocaresolutions.com/ccm-made-simple/
ChartSpan: Chronic Care Management. https://www.chartspan.com/chronic-care-management/
ChartSpan: FAQ. https://www.chartspan.com/faq/
Signallamp Health: Home page. https://www.signallamphealth.com/
Signallamp Health: Transitional Care Management. https://www.signallamphealth.com/transitional-care-management/
Lightbeam Health Solutions: TCM, CCM & Rising Risk Management. https://lightbeamhealth.com/tcm-ccm-rising-risk-management/
Lightbeam Health Solutions: Automated Patient Engagement & RPM. https://lightbeamhealth.com/automated-patient-engagement-rpm/
ThoroughCare: AI patient engagement software (TC Compass). https://www.thoroughcare.net/ai-patient-engagement-software
CareSimple: Remote Patient Monitoring Software. https://caresimple.com/remote-patient-monitoring-software/
About the author
Gautamdev Chowdary is co-founder and CTO of Zynix AI, where he leads engineering for the Zynix platform, its AI agents and ZynixLLM.
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