CMS proposes to add complex care coordination codes in 2015, sets steep requirements

Why This Topic Matters

The article highlights a potential shift in how chronic care coordination may be recognized and paid, which can affect documentation, staffing, technology, and practice workflow planning. It also helps readers track how CMS proposals relate to existing CPT-based care management concepts.

Article Sections

1. Care coordination

   Introduces the CMS proposal for new payment for complex chronic care management services and summarizes the broad policy context. It also contrasts the proposal with existing CPT-based chronic care coordination concepts.

2. 93% of Medicare spend for complex chronic care

   Discusses the Medicare spending context cited in support of better chronic care management. It also references chronic condition categories and the rationale for focusing on beneficiaries with multiple long-term conditions.

3. 24/7 access to care

   Outlines the practice-capability themes CMS associates with providing these services. The section addresses access, communication, staffing, technology, and potential practice qualification considerations at a high level.

4. CMS: You asked for it

   Explains why CMS says it developed the proposal and how it relates to existing evaluation and management payment concepts. It also notes the implementation timing and the agency’s stated reason for seeking public input.