Chronic Care Management (CCM)
In 2015, Medicare began paying separately under the Medicare Physician Fee Schedule (PFS) for CCM services furnished to Medicare patients with multiple chronic conditions. For physicians to capitalize on CCM services, the program required Medicare patients with 2 or more chronic conditions to receive at least 20 minutes of non- face to face staff time directed by a physician per calendar month. The patient must obtain a comprehensive care plan, and have 24/7 access to care providers. When these requirements are met, providers can earn CCM reimbursements averaging $42 per patient per month.
To help physicians and patients alike, CMS has expanded the number CPT codes for Chronic Care Management from 1 to 3 with potential reimbursements ranging from $40 – $94 per month. These new options allow the provider to more adequately serve the patient and receive corresponding reimbursements. CPT 99490 is the standard CPT code for CCM. CPT 99489 and 99487 represent Complex Chronic Care Management and require additional time and physician participation. 99487 requires at least 60 minutes per month and CPT 99489 can be billed for each additional 30 minutes after the initial 60 minutes have taken place.
When CCM first began, CMS anticipated a majority of physicians would take advantage of this new program and its additional revenue opportunities. Yet, initially and still today, a large number of doctors continue to opt-out and refuse to participate. This is surprising as a typical practice with 2,300 patients could expect to generate an additional $75.000 in annual billing …if only 50% of the eligible patients enroll.
Free Practice Analysis
Common reasons why doctors refuse to participate in CCM are “it’s too complicated” and “I don’t have enough staff to run the program” or “it’s too costly to implement a new program, and I don’t want to change my EHR.”. Mercury Global Care was created to help physicians overcome each of these hurdles and start a successful CCM program that will provide enhanced care for their patients and their practice profitability.
MGC uses a technology platform coupled with clinical services to help any practice run a Chronic Care Management program that exceeds CMS requirements and qualifies for maximum reimbursements. Our technology is EHR-agnostic and will work with your current system to improve work flow efficiencies and satisfies new interoperability requirements. Let our clinical team do the heavy lifting of managing the care plan, reaching out to your patients, meeting the 20-minute review requirement, communicating automatically with your EMR and providing accurate reporting to help you confidently bill CMS.
With our simple to run technology coupled with ‘our extension of staff’ clinical support, your practice can be up and running in a very short time. With no burden to existing staff load, no new cost for technology, and no disruption to current systems, there is really no reason to not get started today. Contact us for a free practice analysis and see what your new CCM program can do for your practice.