On January 1st, 2015, the Centers for Medicare and Medicaid Services (CMS) started reimbursing providers who actively manage care delivery for Medicare patients suffering from two or more chronic conditions.

Providers are required to use a certified EHR, obtain and manage patient consent, deliver five core care management services and provide at least 20 minutes of follow-up outside of the office (i.e. non-face-to-face care). The financial upside for providers, however, can be significant-potentially doubling practice billings.

CCM Requirements

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Secure Written Consent

Written consent from eligible beneficiaries must be stored in the patient chart.

Have Five Specified Capabilities

  • Use a certified EHR
  • Maintain an electronic care plan
  • Ensure beneficiary access to care
  • Facilitate transitions of care
  • Coordinate care

Provide Monthly Services

  • 20+ minutes of non-face-to-face care management services per calendar month
  • Services must be administered by licensed clinical staff subject to proper supervision.

Who's Eligible?

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