AHA Coding Clinic® for HCPCS - 2015 Issue 2; For Your Information
The reporting of chronic care management (CCM) services
Since January 1, 2015, non-face-to-face coordination of care services for chronic care management furnished to Medicare beneficiaries with multiple chronic conditions can be reported with CPT code 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 chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline comprehensive care plan established, implemented, revised...
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Article Overview
This article covers chronic care management (CCM) services for Medicare beneficiaries and explains the general reporting context, required service elements, and the kinds of chronic conditions commonly associated with CCM. It is relevant for physicians, qualified health care professionals, clinical staff, and coding/billing professionals who need a high-level understanding of CCM documentation and reporting topics.
Why This Topic Matters
CCM reporting affects how ongoing non-face-to-face care coordination is recognized in Medicare billing workflows. Understanding the article helps readers identify whether the topic applies to their practice and what general documentation and service considerations are discussed.
What You Will Learn
- The Medicare context for chronic care management services
- The broad service elements associated with CCM reporting
- The types of chronic conditions commonly referenced in CCM discussions
- The general time-based nature of the reporting topic
Who Should Read This
- Physicians
- Other qualified health care professionals
- Clinical staff
- Medical coders
- Billers
- Practice administrators
Codes Discussed
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