Medicare Policy: Review 4 Care Management Proposals on the Table

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a set of CMS proposals in the 2020 Medicare Physician Fee Schedule that could reshape care management reporting and service structure. It is relevant to physicians, coders, billing staff, and compliance teams following Medicare payment policy updates and comment-period developments. The discussion focuses on proposed changes affecting transitional care management, chronic care management, complex chronic care management, and the introduction of principal care management.

Why This Topic Matters

Care management services are commonly used in practice, and proposed Medicare policy changes can affect how these services are organized and reported. Staying aware of the proposed updates helps practices evaluate operational impact and prepare for potential final-rule changes.

Article Sections

  1. Change 1: Possible Unbundling of TCM Services

    Discusses a proposed Medicare policy change affecting transitional care management and related service bundling. The section outlines the broader policy context and stakeholder reactions to the proposal.

  2. Change 2: Time Increment Revision for Staff Reporting CCM

    Covers proposed revisions to chronic care management reporting for staff time. The section describes the planned shift to temporary reporting options and notes implementation concerns.

  3. Change 3: New Care Plan Components for Complex CCM

    Summarizes proposed updates related to complex chronic care management and comprehensive care plan elements. The section also references CMS guidance materials tied to care plan content.

  4. Change 4: Launch of New PCM Services

    Introduces proposed principal care management policy changes for patients with a single high-risk condition. The section explains the broader purpose of the new service category and stakeholder response.

  5. Deadline

    Provides the public comment deadline and the general mechanism for submitting feedback on the proposal.

  6. Resource

    Points readers to the proposed Medicare Physician Fee Schedule rule and related federal publication information.

What You Will Learn

  • How CMS is proposing to update Medicare care management policies
  • Which care management service categories are affected by the proposal
  • What general types of reporting and care-plan changes are under review
  • How the proposed additions may affect practices and stakeholders
  • Where and when public comments on the proposal were due

Who Should Read This

  • Medical coders
  • Billing staff
  • Physicians
  • Practice administrators
  • Compliance professionals
  • Care management teams

Codes Discussed

  • CPT: 99495
  • CPT: 99496
  • CPT: 99490
  • CPT: 99487
  • CPT: +99489

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