CMS Chronic Care Management program is there for clinicians who like to care for their patients more than others. There is a good number of people in the US who are need chronic care and medical practices that are providing quality services in this domain are not only doing the society good, they are also aligning themselves in the best position to earn some good incentives from the CMS.
For such good providers who happily care for the 117 million patients with multiple chronic health conditions, the CMS has added four new billing codes.  These new chronic care management codes by CMS are aimed at improving patient care outcomes and compensating clinicians for the additional time they spend in managing these rather complex patients.
The mentioned codes also recognize that primary healthcare contributes to better healthcare and allows medical practices to easily seek separate payments for their CCM services. It has also been observed that nearly two-thirds of Medicare recipients find themselves suffering from two or more chronic conditions.
To get started with this new program the Medicare patient needs to sign an agreement that clearly states their wish to receive chronic care management services. They must also have two or more chronic conditions that are expected to last for at least 12 months. Also every month, the physician treating such patients or any other qualified healthcare professional executing the same duties need to spend at least 20 minutes providing their chronic care patients a non-face-to-face care.
For billing there are four codes that are associated with chronic care management services. They are as follows.

  • CPT code 99490: This allows healthcare professionals in billing for 20 minutes of non-face-to-face care that they successfully provide to a Medicare patient having two or more serious chronic conditions.
  • HCPCS code G0506: This code is actually an add-on to the chronic care management initial visit. It highlights the time spent in giving patients a thorough medical assessment and care planning.
  • CPT code 99487: This code is used for complex chronic care management services which necessitate 60 minutes of clinical staff time and further comprise substantial changes to a healthcare plan with high-or moderate-complexity medical decisions.
  • CPT code 99489: This is just an add-on code for every additional 30 minutes of clinical staff time that is spent on complex chronic care management.

Get all your questions and answers about chronic care management.