decisionhealth Newsletters, Coder Pink Sheets - 2014 Issue 9 (September)
Pay for chronic care management easier in proposed fee schedule
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Article Overview
This article covers proposed CMS changes in the 2015 Medicare physician fee schedule related to chronic care management and related services. It is aimed at physicians, practice managers, coders, and compliance staff who need to understand how the proposed rules affect service delivery, supervision, documentation, patient consent, and electronic health record expectations. The discussion also compares chronic care management with transitional care management and other care supervision services.
Why This Topic Matters
The proposed changes could affect whether practices can bill for chronic care management and how they organize staff, documentation, and technology to support it. It also highlights how related care management services may interact under Medicare billing rules.
Article Sections
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Proposed changes to chronic care management in the 2015 fee schedule
Introduces the CMS proposal and summarizes the overall direction of the changes affecting chronic care management services.
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Rule proposes indirect supervision
Describes changes to supervision requirements for care management services and the role of clinical staff under the proposal.
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The hoops you have to jump through
Reviews the continuing documentation, patient consent, continuity, coordination, communication, and electronic record expectations tied to the service.
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Bill for TCM first then transition to CCM
Explains how chronic care management relates to transitional care management and other supervised care services under the proposal.
What You Will Learn
- How the proposed CMS fee schedule changes affect chronic care management
- What broad operational requirements remain associated with chronic care management
- How supervision and staffing changes may affect practice workflows
- How chronic care management is discussed alongside transitional care management and other Medicare services
- What types of documentation and technology capabilities are emphasized in the proposal
Who Should Read This
- Physicians
- Practice managers
- Medical coders
- Billing staff
- Compliance professionals
- Health care administrators
Codes Discussed
Code Ranges Discussed
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