Chronic Care Management (CCM)

 

 

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The Chronic Care Management (CCM) program began January 1st, 2015, incentivizing physicians with payments for chronic care patients.

What can you charge?

Under the Centers for Medicare & Medicaid Services (CMS) CCM program, physician practices can charge $42.60 per month for 20 minutes of non face-to-face chronic care activity – this can increase your revenue by thousands! Let’s say for example, a practice bills a patient for 12 months. That’s $511.20 for one patient. Multiply that by 50 patients, and that’s $25,560 annually in additional revenue!

Eligibility

Physicians, Physician Assistants, Clinical Nurse Specialists, Nurse Practitioners and Certified Nurse Midwives can bill for CCM services. Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) are also eligible to bill CCM services. To count towards CCM payments, the services must be done outside of regular office visits and the patient must also have more than one chronic condition, expected to last 12 months or more.

It is important to note, only one practitioner per patient is eligible to receive CCM payments over a given calendar month.

Service Codes That Provide Payment for Coordinated Care

CPT Code: 99490CPT Code: 99489
CPT Code: 99487HCPCS Code: G0506