Get Paid for Providing Chronic Care Management Services

Read Family Practice Management Supplement

July 27, 2017 01:53 pm News Staff

Chronic care management (CCM) services can provide family medicine practices with a new revenue stream even as physicians are taking steps toward future value-based payment.  

[Tablet with Chronic Disease written on screen and stethoscope lying on it]

Just how much potential revenue is at stake? According to a supplement offered in the July/August Family Practice Management (FPM) titled "Making Sense of MACRA: Simplifying Chronic Care Management," practices that provide these services could increase their monthly income, based on national averages, by

  • $1,050 for 25 patients;
  • $2,100 for 50 patients; and
  • $4,200 for 100 patients.

The supplement aims to guide family physicians through a step-by-step process to achieve success in offering -- and getting paid -- for providing these services to their Medicare patients.

First, for those unfamiliar with this topic, CMS defines CCM as nonface-to-face services provided to Medicare beneficiaries who have two or more chronic conditions that are expected to last at least 12 months.

CMS began paying for these services in 2015, with updates in 2017.

The FPM supplement walks physicians through implementing chronic care management and explains how to

  • identify patients with CCM needs,
  • discuss CCM services,
  • obtain patient consent,
  • develop and share a personalized patient care plan,
  • coordinate nonface-to-face care, and
  • bill for CCM services.

Family Physician Shares CCM Successes

Karen Smith, M.D., the AAFP's 2017 Family Physician of the Year, provides chronic care management (CCM) services to eligible Medicare patients in her family medicine practice in the small rural community of Raeford, N.C.

Watch this short video(www.cms.gov) CMS posted recently and listen as Smith describes how adding CCM to her menu of health care services benefits both her patients and her practice.  

Readers are urged to consult the AAFP's Chronic Care Management Toolkit -- available for purchase online -- for additional details on elements required to code for CCM, as well as access to a full array of additional resources.

The supplement explains how to track time spent providing CCM services and how providing this care to Medicare patients helps physicians prepare for CMS' Quality Payment Program.

According to the supplement's authors, physicians and their clinical teams likely already spend time coordinating care for patients with comorbid conditions such as diabetes, coronary artery disease and congestive heart failure. "CCM allows you to bill for this time," they say.

Put simply, "CCM can help manage your patients' chronic conditions more effectively, improve communication among other treating clinicians, and provide a way to optimize revenue for your practice."