Chronic Care Management (CCM)
Healthcare providers, regardless of specialty, are eligible to receive additional revenue for non-face-to-face chronic care management services per patient, per calendar month for Medicare Part B patients with two or more chronic conditions.
Patient must be diagnosed with 2 or more chronic conditions expected to persist at least 12 months (or until death) that place the individual at significant risk of death, acute exacerbation/decompensation, or functional decline.
- CMS maintains a CCW (Chronic Care Warehouse) that provides information on 22 specified chronic conditions for reference. https://ccwdata.org/web/guest/condition-categories
|In 2017, a Certified EHR is required to standardize formatting in the medical record of core clinical information (demographics, problems, medications, medication allergies) but is not required for other CCM documentation or transitional care management documents.
2017 Chronic Care Management (CCM) Rates
|CPT Code||Payment (per patient, per month)||Time/Work|
|CCM- 99490*||$43||20 minutes or more of clinical staff time in qualifying services|
|Complex CCM – 99487||$94||60 minutes|
|Complex CCM Add-On – 99489 (use with 99487)||$47||Each additional 30 minutes of clinical staff time|
*CPT code 99490 is subject to a patient coinsurance (around $8) unless patient has a secondary insurance that will cover.
Interested in Outsourcing the Clinical Side of Chronic Care Management?
Evaluate whether your practice can handle CCM in-house or outsource:
- 1 FTE to do CCM for 200 patients
- Determine resources needed to do in-house
- Outsourcing candidates w/ MediSYS Partner
- More than 1,000 Medicare Patients
Outsourcing your chronic care management tasks can help you meet 34 measures under the MIPS program. Contact MediSYS for more information!
MediSYS can help you outsource full service CCM services while still increasing your revenue and saving you time to work on other aspects of MIPS!
MediSYS has the tools within MediSYS EHR and the knowledgeable staff available to help you meet the requirements for Chronic Care Management billing! Use the Chronic Care Management Calculator to determine possible revenue generated by participation in Chronic Care Management.
View the final rule at the U.S. Office of Federal Register.