Did you know that mostphysicians provide Chronic Care Management to your patients but only few collect payments for that?
In 2015,
Medicare began paying separately under the Medicare Physician Fee Schedule
(PFS) for CCM services furnished to Medicare patients with multiple chronic
conditions.
Examples of chronic conditions include, but are not limited
to, the following:
·
Alzheimer’s
disease and related dementia
·
Arthritis
(osteoarthritis and rheumatoid)
·
Asthma
·
Atrial
fibrillation
·
Autism spectrum
disorders
·
Cancer
·
Cardiovascular
Disease
·
Chronic
Obstructive Pulmonary Disease
·
Depression
·
Diabetes
·
Hypertension
·
Infectious
diseases such as HIV/AIDS
Why Chronic Care Management?
When patients with chronic conditions actively participate in their healthcare, their overall care coordination and outcomes improve, meaning fewer hospitalizations and trips to the emergency room.
The Chronic Care Management program entitles Medicare patients* with two or more chronic conditions to receive additional care coordination benefits that will help improve their health. In many cases, chronic conditions are readily treatable and proactive steps can change outcomes so that individuals experience more fulfilling lives.
When patients with chronic conditions actively participate in their healthcare, their overall care coordination and outcomes improve, meaning fewer hospitalizations and trips to the emergency room.
The Chronic Care Management program entitles Medicare patients* with two or more chronic conditions to receive additional care coordination benefits that will help improve their health. In many cases, chronic conditions are readily treatable and proactive steps can change outcomes so that individuals experience more fulfilling lives.
Medicare Payment:
The
program is designed to reimburse an average of $42 per month for each patient
enrolled in a chronic care management program under a specific set of
circumstances.
CPTs:
CPT 99490
|
Chronic care management services, at least 20 minutes of
clinical staff time directed by a physician or other qualified health care
professional, per calendar month, with the following required elements:
Multiple (two
or more) chronic conditions expected to last at least 12 months, or until the
death of the patient
|
|
CPT 99487
|
Complex chronic care
management services, with the following required elements:
Multiple (two
or more) chronic conditions expected to last at least 12 months, or until the
death of the patient
Chronic
conditions place the patient at significant risk of death, acute
exacerbation/ decompensation, or functional decline
Establishment
or substantial revision of a comprehensive care plan
|
|
CPT 99489
|
Each additional 30 minutes of clinical staff time directed by a
physician or other qualified health care professional, per calendar month
(List separately in addition to code for primary procedure)
|
Zen Medical
Services is a Medical Billing Agency in Bay
Area. We provide Medical
Billing and Management Services to the doctors in Bay Area and across the
United States.
We help with Physician
billing which includes – Eligilbity, Authorizations, Charge Entry, Payment
Posting, Denial Management, Appeal, Patient Statements, Credentialing,
Contracting and MACRA/MIPS Reporting.
For more on
how to bill for CCM services, call us today 408 673 0936
Sincerely,
Binta
Patel
Zen
Medical Services
Your Medical Billing Specialist
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