Chronic Care Management (CCM)


CMS Chronic Care Management Services

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 has created Connected Care: The Chronic Care Management Resource campaign designed to raise awareness of the benefits of CCM for patients with multiple chronic conditions and provide health care professionals with resources to implement CCM.

CCM Health Care Professional Resources

Chronic Care Management (CCM) Codes

CPT Code Time/Work
CPT Code 99490* Bill for at least 20 minutes of non-face-to-face clinical staff time directed by a physician or other qualified health care professional per calendar month for Medicare patients with multiple chronic conditions.
CPT Code 99487 For complex CCM that requires establishment or substantial revision of a care plan, moderate or high complexity medical decision making, and 60 minutes of clinical staff time.
CPT Code 99489 Add-on code to complex CCM (CPT code 99487) for each additional 30 minutes of clinical staff time.
HCPCS Code G0506 Add-on code to the CCM initiating visit that describes the work of the billing practitioner in a comprehensive assessment and care planning to patients outside of the usual effort described by the initiating visit code.

*CPT code 99490 is subject to a patient coinsurance unless patient has a secondary insurance that will cover.

Chronic Care Management MediSYS has the tools 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.

Resources:

http://www.pyapc.com/white-paper-details-new-medicare-payment-chronic-care-management/

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1516.pdf

http://dashboard.healthit.gov/quickstats/pages/FIG-Chronic-Care-Management-Fee-Tool.php

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ChronicCareManagement.pdf

https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/chronic-care-management.html

View the final rule at the U.S. Office of Federal Register.