According to information compiled by the CDC one in four adults have two or more chronic conditions. 86% of the nation’s $2.7 trillion in healthcare expenditures are for people with chronic and mental health conditions. In response, Medicare created Chronic Care Management (CCM) benefits in a per-patient-per-month-model, offering an average $43 per month payment for 20 minutes of telephone consultation.

With the estimated additional six figure practice incomes, few practices have participated. As a matter of fact, companies were created to schedule and enroll the patients, then provide the care, and document the interactions plus tell the practice what to bill. Yet participation lags.

New relaxed guidelines and higher reimbursements beginning 1/1/2017 should increase participation and perhaps encourage you to consider jumping in.

Added to the 99490 (average $43) for 20 minutes of care per month is now:

  • 99487 (average $94) for Complex CCM
  • 99489 (average $47) for each additional 30 minutes of care, and
  • GO506 (average $64) for planning and assessment of CCM

As of 1/1/17 a face to face visit to get enrolled in CCM is no longer required if the patient has been seen within the last year.   Also, consent given by the patient to participate can be verbal rather than written. Part of patient communication for Chronic Care Management allows texts and emails.   Furthermore, Chronic Care Management does not require EMR documentation. And the care plan given to the patient can be in a format of the practice’s choosing.

Chronic Care Management is NOT only for primary care doctors.  It is important to note only one provider per month can be reimbursed for Chronic Care Management services.

Here is a list of other specialists that can participate.

  • Cardiology
  • Endocrinology
  • Oncology
  • Internal Medicine
  • Pain
  • Pulmonology
  • Sleep Medicine
  • Urology
  • Dermatology
  • Rheumatology
  • Psychiatry
  • Ophthalmology

All things considered, contact us for additional contact information. We can provide contacts at companies who can integrate a Chronic Care Management program into your practice with no upfront cost and for less effort than you may think.