Chronic Care Management

healthcare consultant complianceMany providers are considering adding Chronic Care Management (CCM) to their practice.  Three years ago (Jan 2015), CMS began reimbursing separately under the Medicare Physician Fee Schedule for chronic care management for patients with 2 or more chronic conditions.  Physicians, PAs, NPs, CNS’, and Certified Nurse Midwives can bill code 99490 for a minimum of 20 minutes treating patients with chronic conditions that place their patients at significant risk of death, acute exacerbation or functional decline.  An initiating face-to-face visit (Annual Wellness or Initial Preventive Physical Exam), documented patient consent (verbal or written) that informs them regarding CCM services’ availability, cost-sharing, and their right to stop CCM are required by Medicare to begin this service. Along with the initiating visit, structured records using certified EHR software, 24/7 access and continuity of care, comprehensive care management and a Comprehensive Care Plan are also required.  Only one practitioner can provide services and bill during a calendar month, but the added reimbursement for practitioners’ time in caring for their patients make this a viable, but underutilized program.  Using an independent healthcare consultant compliance professional or CCM company is one of the easiest and fastest ways to kickstart a program.

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