decisionhealth Newsletters, Part B News - 2025 Issue 10 (October)
Care management codes rise from COVID depths; so do some denials
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Article Overview
This article examines Medicare claims patterns for care management services over a multi-year period that includes the COVID-19 era and the recovery that followed. It is useful for coders, billing staff, compliance teams, and practice leaders who monitor utilization trends and denial rates for care management services. The discussion focuses on broad changes in claim volume and denial patterns across chronic care management, transitional care management, and principal care management code families.
Why This Topic Matters
Tracking how care management services performed during and after the pandemic can help stakeholders understand shifting utilization and payer scrutiny. The article highlights trend changes that may be relevant for revenue cycle monitoring, denial analysis, and service-line planning.
What You Will Learn
- How Medicare claims activity changed over time for major care management service families.
- Which care management service categories are discussed in the context of utilization and denial trends.
- What kinds of denial pattern changes are reported across the years covered by the article.
- How the article frames pandemic-era disruption and later recovery in care management billing.
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Compliance professionals
- Practice managers
- Healthcare administrators
Codes Discussed
Code Ranges Discussed
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