Advancing the Chronic Care Management Fee, Telemedicine

From AAFP. org:

“Family physicians applaud the planned payment of a new chronic care management (CCM) code,” said Wergin in the statement, “because it is a step toward recognizing the value of the often complicated clinical oversight that — although needed by many Medicare beneficiaries — requires significant clinical time outside the exam room.”

Wergin referred to the fact that, beginning in 2015, CMS will pay $42.60 for a “one-per-month, per-patient CCM code.” And rather than using its proposed “G” code to report CCM services, the agency changed course in the final rule to allow physicians to utilize CPT code 99490 for CCM reporting purposes.

“As a result of implementing payment for this code, elderly and disabled patients will have better access to the care they need to reduce and avoid complications of their conditions and expenses that come with treating such complications,” said Wergin.

CMS also nixed its initial proposal that would have required physicians to use 2014 certified technology to bill for CCM services. Instead, physicians will be able to use whatever certified EHR version they were using on Dec. 31 of the previous calendar year to do so.

While CMS strongly recommends that a provider furnish an Annual Wellness Visit (HCPCS G0438, G0439) or an initial preventive physical exam (G0402) to the beneficiary, there are no prerequisite services required to bill for CCM.

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