Complex Chronic Care Services (November 2013)

November 2013 pages 3-5 Complex Chronic Care Services A new subsection titled "Complex Chronic Care" was added to the Evaluation and Management (E/M) services section of the Current Procedural Terminology (CPT®) 2013 code set to address the need for coordination and management of care performed by multiple disciplines and community service agencies and the management of chronic disease. This article will provide an overview of the evolving complex chronic care services and guidelines for reporting these services. Complex chronic care services are patient-centered management and support services provided by physicians, other qualified health care professionals, and clinical staff...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews the CPT framework for complex chronic care services introduced in the 2013 code set. It is aimed at clinicians, coders, and practice staff who need to understand the scope of the service, monthly reporting structure, documentation expectations, and how the guidance relates to other E/M and care coordination services. The discussion also covers general operational and payer-related considerations surrounding reporting.

Why This Topic Matters

Complex chronic care reporting affects how ongoing multidisciplinary management is documented and billed. Understanding the article helps practices evaluate whether their workflows, care plans, and monthly coordination activities align with CPT guidance and related service limitations.

Article Sections

  1. November 2013 pages 3-5

    Introductory overview of the article’s subject matter and the general purpose of the guidance. It frames the discussion around complex chronic care services in CPT and their role in ongoing patient management.

What You Will Learn

  • The general purpose and scope of complex chronic care services in CPT guidance
  • How monthly care coordination is framed at a high level
  • What kinds of documentation and practice capabilities are emphasized
  • How the article situates complex chronic care services alongside related E/M and care management topics

Who Should Read This

  • Physicians
  • Other qualified health care professionals
  • Clinical staff
  • Medical coders
  • Billing staff
  • Practice managers

Codes Discussed

Code Ranges Discussed


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