Medicare launched the Chronic Care Management (CCM) services initiative in 2015.
This program is designed to reimburse clinical practices for the time spent providing non-face-to-face care to patients with 2 or more chronic medical conditions, maintaining a comprehensive care plan, and meeting other requirements
The service is oriented towards primary care providers, but other specialties may offer these services if they are managing all the patient’s medical conditions. CCM has proven value (as per CMS) in improving the quality of care provided patients and reducing the overall cost of care.
There are several reimbursable codes associated with CCM services. Medicare will pay between $41 and $120 (or more) per month depending on the types of CCM services provided. CCM services may be provided during the same month as telehealth visits, transitional care management and other services.
CMS has temporarily lifted some of the requirements for CCM, making now a good time to explore offering the services to your patients. This program has been underutilized in the past, but represents an opportunity for practices to provide care and create new revenue streams during and after the current pandemic.
Medicare also approved reimbursement for a new program in 2020 referred to as Principal Care Management (PCM) services. This program is similar to CCM but reimburses specialists for the non-face-to-face care they provide to patients with one or more chronic conditions.
This presentation will review in detail the requirements for CCM and PCM services and their potential levels of reimbursement. It will also review how to implement these services, and how to avoid potential pitfalls.
Why you should Attend: During the current pandemic practices are shifting away from face-to-face care, including telehealth and remote physiologic monitoring. However, CCM and PCM can be provided and billed for during the same month as telehealth visits. These initiatives represent optimal ways to capture revenue while providing enhanced care to patients. A practice that cares for Medicare patients would be well advised to gain understanding of CCM and/or PCM services and consider them for their organization.
Areas Covered in the Session: