Fam Pract Manag. 2017 Mar-Apr;24(2):36.

Author disclosure: no relevant financial affiliations disclosed.

New and improved rules for chronic care management


What are the 2017 changes to Medicare's requirements for chronic care management?


Medicare has expanded coverage for chronic care management (CCM) and has relaxed some of the billing requirements. The key changes are as follows:

  • Medicare now covers complex CCM (code 99487 for the first 60 minutes per month, and code 99489 for each additional 30 minutes per month),

  • An initiating visit is required only for new patients or patients not seen within one year prior to the start of CCM,

  • When an initiating visit is required, add-on code G0506 is billable if beneficiaries require extensive face-to-face assessment and care planning by the billing provider (as opposed to clinical staff),

  • Patient agreement to receive CCM services no longer has to be written; it can be verbal and documented in the medical record,

  • Physicians are no longer required to obtain patient authorization for electronic communication of medical information with other treating providers,

  • Medicare adopted CPT language to clarify that “24/7 access” applies to urgent care needs and ensures access to the care team, not necessarily the individual physician,

  • Medicare no longer specifies how providers must share continuity of care documents,

  • Medicare now requires timely electronic sharing of care plan information within and outside the billing practice, but not necessarily on a 24/7 basis, and allows transmission of the care plan by fax.

For more information about the changes, see “New Codes, New Payment Opportunities for 2017,” FPM, January/February 2017.

Dietitian “incident-to” billing


Should a registered dietitian's services be billed “incident to” a physician's services?


It depends on the service rendered and the payer. Medicare allows a registered dietitian (RD) to provide most services in continuation of a physician's plan

About the Author

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Cindy Hughes is an independent consulting editor....

Author disclosure: no relevant financial affiliations disclosed.

Reviewed by the FPM Coding & Documentation Review Panel: Kenneth Beckman, MD, MBA, CPE; Robert H. Bösl, MD, FAAFP; Marie Felger, CPC, CCS-P; Thomas A. Felger, MD, DABFP, CMCM; Emily Hill, PA-C; Joy Newby, LPN, CPC; and Susan Welsh, CPC, MHA.


Send questions and comments to, or add your comments below. While this department attempts to provide accurate information, some payers may not accept the advice given. Refer to the current CPT and ICD-10 coding manuals and payer policies.


Copyright © 2017 by the American Academy of Family Physicians.
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