Bill for Chronic Care Management Services With Confidence

Explore FPM's Tools, Resources

December 12, 2014 01:52 pm Sheri Porter

AAFP President Robert Wergin, M.D., shown here tending to a patient in his clinic in Milford, Neb., sees patients of all ages and looks forward to implementing Medicare's new chronic care management code on Jan. 1.

December is a busy month for family physicians, but be sure you set aside a little reading time to get up to speed on the new chronic care management (CCM) code made available to physicians as of Jan. 1.

Check out the Family Practice Management article "Chronic Care Management and Other New CPT Codes," which was published online ahead of print and is chock-full of details FPs will want to have under their belts come the new year.

The article, authored by Kent Moore, the AAFP's senior strategist for physician payment, covers all the important topics, such as patient eligibility, practice standards, scope of services, coding, billing and documentation, and CCM and "incident to" rules.

There's a lot to learn about this rule, and the article details it all. For instance, the new CCM benefit

Story Highlights
  • Family Practice Management offers family physicians an online-first article designed to help them get up to speed on Medicare's new chronic care management code.
  • As of Jan. 1, physicians can bill for chronic care management services provided to patients with two or more chronic conditions using CPT code 99490.
  • The FPM article includes three customizable resources, a frequently-asked-questions document and an invitation for physicians to register for a free January webinar on the topic.
  • pertains only to patients with two or more chronic conditions;
  • comprises eight elements, including access to care, continuity of care and management of care transitions;
  • requires the sharing of patient information via certified electronic health record technology; and
  • dictates that a signed patient agreement be collected before services begin.

The article also devotes a fair chunk of space to coding, billing and documentation. To bill Medicare for CCM services, physicians must use CPT code 99490, but the article will fill FPs in on those all-important details that mean the difference between getting a check for payment or receiving a claims rejection.

FPM also offers readers three downloadable tools designed to save physicians time as they venture into these uncharted waters. They are

FPM also hammered out a list of frequently asked questions meant to assist family physicians in understanding how the new code is to be used.

Register Now for Free CCM Code Webinar

To ensure that family physicians have all the information they need about the chronic care management code they may begin using on Jan. 1, the AAFP will present a free webinar on Jan. 27 from 12:30-1:30 p.m. CST. The webinar, titled "Getting Paid for Chronic Care Management Under Medicare in 2015," will cover need-to-know information and have time reserved for questions and answers. Register now( for this timely event anchored by Kent Moore, the AAFP's senior strategist for physician payment.

Why all the extra effort devoted to this topic?

In an interview with AAFP News, Moore pointed out that payment for CCM services has been a long time coming.

"This represents a unique opportunity for our members to finally get paid for services that many of them already have been providing without payment," said Moore. "These codes are aimed at compensating family physicians not just for what they're doing, but for the value they bring to their patients." And that value goes far beyond the face-to-face interactions that happen every day in family physician practices, he added.

The tools FPM created to accompany the article should be a valuable aid to physicians, said Moore.

"These three tools are intended to give family physicians what they need -- or at least a place to start -- and all of them are customizable to individual practices," he said. One in particular, the CCM services log, is designed to document the clinical staff time devoted to a patient who received CCM services during the course of a calendar year and could be particularly important.

"It's intended to help family physicians capture the information they would need to withstand a Medicare audit," said Moore.