Treat Patients With Multiple Chronic Conditions? You Could Be Leaving Money on the Table

Just over two years ago, CMS adopted a new service code to improve payment and access to chronic care management (CCM) services for Medicare and dual eligible beneficiaries who have two or more serious chronic conditions.

Unfortunately, many doctors don’t know how to bill under the chronic-care management code and have been leaving money on the table. In fact, CMS only received chronic-care claims for 513,000 beneficiaries by the end of 2016.

To help educate clinicians about the chronic care management codes, CMS has launched the Connected Care: the Chronic Care Management Resource. This Connected Care program offers two toolkits:

  1. The Health Care Professional Toolkit provides detailed information about chronic care management practices, procedures, and benefits. The resource is a guide for professionals looking to integrate chronic disease management into their care strategies.
  2. The Partner Toolkit provides a detailed overview of Connected Care program, as well as downloadable resources and suggested activities as a way to promote Connected Care involvement.

The campaign also highlights a series of regulatory changes made this year to incentivize billing for care management. The agency raised the reimbursement amount for the care-management code by $1 per use, and introduced three new chronic-care management codes. The codes pay more depending on the complexity of the patient’s needs. The new reimbursement scale ranges from $43 to over $141.

For more information on how to get involved with the CCM initiative and learn more about chronic care management, visit go.cms.gov/ccm.

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