Bill for Chronic Care Management, Boost Your Bottom Line

Learn More in AAFP Webcast

April 08, 2016 02:56 pm Sheri Porter

Family physicians have perfected the art of managing patients with multiple chronic conditions, but they haven't always been fairly paid for their expertise or the extra time these patients require.

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That situation is changing thanks to the Jan. 1, 2015, implementation of CPT code 99490 that established Medicare payment of about $42 per patient per month to physicians providing chronic care management services that include phone calls, emails, referrals to other health professionals, prescription review and ongoing oversight of a patient's status.

Physicians not familiar with this code -- or who simply have not yet eased its use into their workflow -- should learn about it now.

Purchase access to an AAFP webcast to understand how this code can provide a new revenue stream for your practice. AAFP members pay $30; non-members $110.

The one-hour webcast, titled "Chronic Case Management -- Getting Paid for What We Do Best," will be presented April 20 at noon CDT.

Let family physician Leisa Bailey, M.D., of Bonifay, Fla., serve as your guide on this journey.

Bailey told AAFP News she's been in private practice in her Florida community for 23 years and started doing formal chronic care management -- using the CPT code 99490 -- in January 2015.

"Ideal patients are those with conditions like COPD (chronic obstructive pulmonary disease), CHF (congestive heart failure) and diabetes, but it works well with all chronic conditions," she said.

"In my small practice one of my nurses spends about half of her time doing nothing but chronic care. She more than pays for herself and we have been able to add a medical assistant and a scribe for me in part because of the extra income we receive from utilizing the code," she added.

Bailey called the situation a "win-win" opportunity.

"We are taking better care of our patients, their health maintenance stays up to date, and the patients love the extra attention. We are keeping patients out of the hospital and I like not having to get up early to make rounds as often."

Bailey also welcomed the financial boost "in an environment where our pay seems to be getting cut in so many areas."

She noted that she currently has about 150 patients in the chronic care management program but that numbers were increasing every month. And staying in touch monthly with the patients has added benefits.

For instance, the nurse who makes those calls ensures that the patients get scheduled for their yearly wellness exams and other wellness activities for which the practice receives payment -- including advance care planning counseling, smoking cessation counseling and flu shots.

Don't pass up the opportunity to get paid for the chronic care management work you're already doing!

An application for CME credit for this webcast has been filed with the American Academy of Family Physicians. Determination of credit is pending.

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(12/12/2014)