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.
With the publication of the 2016 Medicare Physician Fee Schedule, Medicare reaffirmed its commitment to reimbursing for chronic care management, or CCM. With the establishment of CPT code 99490, CMS enabled providers to begin billing for CCM services so long as they satisfy three core requirements:
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.
To learn more about Chronic Care Management, download and read this white paper.White Paper
To hear what one CIO has to say about CCM and the role of technology in transitioning to value-based care, watch this brief video.Video
Medicare is reimbursing physicians approximately $43 per eligible beneficiary per month-that's about $500 for each patient over the course of the year.
Use our CCM Revenue Calculator to gauge the financial impact on your practice.Calculator