Chronic Care Management: 9 Factors Your CCM Records Must Include

Why This Topic Matters

CCM can create recurring monthly revenue, but only when the practice can support the required workflow and documentation. Readers need this overview to assess whether their EHR, care coordination processes, and consent procedures are aligned with the service requirements.

Article Sections

1. Overview of CCM reporting and payment context

   Introduces the CCM topic, the Medicare payment context, and why the service became relevant for practices. It also frames the article around billing and documentation concerns raised in a CMS webinar.

2. Nine required CCM elements

   Explains that the service depends on meeting multiple required documentation and workflow elements. The section outlines the broad categories of recordkeeping, access, coordination, communication, and consent covered in the article.

3. EHR and care plan requirements

   Covers the electronic record and care plan components discussed for CCM. It focuses on the general need for structured documentation and availability of information across the care team.

4. Care transitions and electronic communication

   Discusses information exchange with other providers and the role of electronic communication tools. It also addresses workflow issues that may arise when transmission methods are limited.

5. Home- and community-based coordination, communication, and consent

   Summarizes the remaining CCM elements involving coordination with outside services, patient and caregiver communication options, and documentation of beneficiary consent. It emphasizes the compliance and recordkeeping aspects of these requirements.