Rules and regulations: Read the fine print for community health integration services

Why This Topic Matters

Practices considering CHI services need to understand the proposed requirements before investing time and resources. The article highlights the kinds of operational, staffing, and documentation issues that may affect whether a practice can participate successfully.

Article Sections

1. Overview of proposed community health integration services

   Introduces the CMS proposal and the general purpose of the new service within care management. Summarizes why the topic may be relevant to practices considering additional service lines.

2. An E/M visit comes first

   Explains the proposed relationship between CHI services and an initiating evaluation and management encounter. Describes the general categories of visits discussed in the proposal.

3. CHI performed incident-to, under general supervision

   Covers proposed supervision and staffing arrangements for the service. Discusses the role of auxiliary personnel and the possibility of contracted support through outside entities.

4. Certain restrictions apply

   Summarizes proposed limits intended to reduce overlap and duplication with other care management activities. Notes the discussion of patient-level and monthly billing limitations.

5. Training, state law define auxiliary personnel

   Describes how state law and training expectations may affect who can furnish the service. Includes the general categories of competencies CMS identifies for auxiliary personnel.

6. Time, services must be documented

   Addresses documentation and recordkeeping expectations for time spent and activities performed. Also notes the article’s discussion of coding references related to social determinants of health.