Chronic Care Management
Getting Paid for What We Do Best
The Centers for Medicare & Medicaid Services (CMS) recognizes that chronic care management (CCM) is a critical component of primary care that promotes better health and reduces overall health care costs.
In 2015, using CPT code 99490, CMS began paying separately for non–face-to-face care coordination services furnished to Medicare beneficiaries who have two or more chronic conditions that are expected to last at least 12 months (or until the death of the patient). Examples of covered services include phone calls and emails to a patient to discuss management of chronic conditions, management of referrals to other providers, management of prescriptions, and ongoing review of patient status.
Beginning in 2017, CMS also implemented separate payment for complex chronic care management using CPT codes 99487 and 99489. Complex CCM shares common required service elements with CCM, but has different requirements for the amount of clinical staff service time provided, the complexity of medical decision making involved, and the nature of the care planning performed. Through CPT codes 99490, 99487, and 99489, family physicians and other eligible health care professionals can be reimbursed by CMS for providing CCM services to their patients.
About the Webcast
Chronic Care Management: Getting Paid for What We Do Best
After view this webcast, you should be able to:
- Review CMS Chronic Care Management (CCM) requirements and summarize visit elements.
- Identify how CCM can manage chronic conditions to close care gaps and engage patients.
- Assess financial and quality implications of incorporating CCM as a means of practice improvement.
- Recognize the importance of CCM in relation to value-based payment.
Estimated time required to complete the full webcast: 50 minutes
Original release of webcast: May 2017.
Leisa Bailey, MD
Dr. Bailey is originally from Texas and is a graduate of Houston Baptist University and Baylor College of Medicine. She completed her family medicine residency at Eglin Airforce Base Regional Hospital and opened a solo private practice in the small Florida Panhandle town of Bonifay, Florida, after serving at Tyndall Airforce Base and in Saudi Arabia during Operation Desert Storm.
Dr. Bailey and her husband, James, raised their family in Bonifay, where she has been in practice for over 20 years. She enjoys practicing the full spectrum of family medicine including pediatrics, obstetrics, geriatrics, and emergency medicine. She also enjoys teaching the many medical students who rotate through her office from Florida State University and The University of Florida.
The material presented here is being made available by the American Academy of Family Physicians for educational purposes only. Please note that medical information is constantly changing; the information contained in this activity was accurate at the time of publication. This material is not intended to represent the only, nor necessarily best, methods or procedures appropriate for the medical situations discussed. Rather, it is intended to present an approach, view, statement, or opinion of the faculty, which may be helpful to others who face similar situations.
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