CCM is a CMS initiative calling for non-face-to-face time per calendar month by a physician (primary care or specialist), or other qualified healthcare providers (see next paragraph) with patients having at least two chronic conditions, each expected to last at least 12 months or until the patient’s death, and where a comprehensive treatment plan for the patient can be established, implemented, and monitored.
The following health care professionals can bill for CCM services: Physicians, Physician Assistants, Clinical Nurse Specialists, Nurse Practitioners, and Certified Nurse Midwives. Caveat: only one practitioner per patient may be paid for CCM services for a given calendar month. Federally Qualified Health Centers, Rural Health Clinics, and Critical Access Hospitals can also bill for CCM services.
CCM gives multiple chronic care patients almost limitless access to their provider in an effort to at least keep them stabilized, if not improved.
Reimbursement averages approximately $40 per patient/per monthly submission. Rates are higher or lower based on the submitter’s location. This is based on code 99490. You should be able to calculate your potential revenue based on your own patient population’s parameters using the conditions mentioned above. That revenue can be quite significant.
An EHR such as the MedicsCloud EHR from ADS is ideal to use for CCM reporting.
It also helps to have a reliable CCM resource guiding you toward your compliance.
Simply complete the Request Information form for more details on our Medics solutions for initiatives and incentives, and how to easily take advantage of CCM.