decisionhealth Newsletters, Part B News - 2014 Issue 11 (November)
Chronic care management payments arrive with revenue opportunity, hurdles
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Article Overview
This article covers Medicare chronic care management payment policy under the 2015 physician fee schedule, including the service’s billing framework, documentation expectations, electronic information-sharing requirements, and beneficiary cost-sharing issues. It is relevant to physicians, practice managers, billing staff, and compliance professionals who need a high-level understanding of whether chronic care management fits their workflow and patient population.
Why This Topic Matters
Chronic care management can create recurring reimbursement opportunities, but it also introduces operational, documentation, technology, and patient-communication requirements that practices must evaluate before offering the service.
Article Sections
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Billing and payment overview
Introduces the Medicare chronic care management payment change and explains the general timing and monthly billing framework.
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Requirements to bill CCM
Summarizes the service structure, staffing, supervision, and electronic health record-related requirements associated with chronic care management.
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Ask for the money
Discusses beneficiary cost-sharing, consent, and communication issues tied to the service.
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Determine whether CCM is worth it
Reviews practice-readiness considerations, staffing implications, and the broader operational fit of chronic care management.
What You Will Learn
- How Medicare’s chronic care management payment was introduced in the 2015 physician fee schedule
- What types of operational and documentation areas practices should evaluate before offering the service
- Why electronic information-sharing and care-plan workflows matter for CCM
- What beneficiary consent and cost-sharing issues are associated with the service
- How practices can assess staffing and workflow readiness for chronic care management
Who Should Read This
- Physicians
- Practice managers
- Medical billers and coders
- Compliance professionals
- Healthcare administrators
Codes Discussed
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