Avicenna Medical Blog

2022 Medicare Care Management Updates - CCM, PCM and RTM

Posted by DeAnn Dennis on Thu, Mar 17, 2022 @ 11:42 AM

Overview; CCM, PCM and RTM Program Updates:

If you are planning to offer, or currently offer chronic care management or remote monitoring services to your patients, CMS is providing more financial incentive with new billing codes and increased reimbursement rates. 

CMS significantly increased the reimbursement rate for Chronic Care Management and created a new add-on code for provider time spent managing CCM patients.  

Principal Care Management also received a significant reimbursement increase...

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Medicare Care Management Updates - 2020

Posted by DeAnn Dennis on Tue, Nov 19, 2019 @ 11:11 AM

Care Management in 2020:

Each year, CMS makes updates to the Medicare care management programs to create more financial reimbursement opportunities for providers and improve the health outcomes of their patients. This year's final rule for the Physician Fee Schedule contains modifications to payment rates, payment policies, and quality provisions. These updates will be officially implemented on January 1, 2020.

TCM Program Updates:

Transitional Care Management focuses on reducing unnecessary...

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Medicare Care Management Programs - 2019

Posted by DeAnn Dennis on Thu, Oct 10, 2019 @ 12:13 PM

CMS Care Management Programs - History and Overview:

In 2013, CMS introduced Transition of Care Management (TCM), reimbursing providers for furnishing care to patients transitioning from the hospital to their home. Two years later, the Chronic Care Management (CCM) program was launched to promote better outcomes and reduce the cost of care for patients living with two or more chronic conditions. To expand on the established Annual Wellness Visit (AWV) benefit, CMS introduced Advanced Care...

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2018 Updates to Medicare's Behavioral Health Integration Program

Posted by DeAnn Dennis on Tue, Jul 03, 2018 @ 11:00 AM

Behavioral Health Integration Program:

Behavioral health integration (BHI) was added to Medicare’s care management programs in January 2017, reimbursing physicians and non-physicians for BHI services provided to patients with mental, behavioral, or psychiatric conditions. Since the introduction of BHI, Medicare has continued to update the billing codes and expand the reimbursement opportunities for providers aiding the millions of Americans living with a mental health disorder.


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2018 Updates to Medicare Care Management Programs

Posted by DeAnn Dennis on Thu, Apr 19, 2018 @ 04:14 PM

Care Management Programs Overview:

Beginning in 2013, the Centers for Medicare and Medicaid Services introduced transition of care management (TCM), reimbursing providers for helping their patients with the transition from hospital to home.  Following the introduction of TCM; in 2015 CMS introduced the original chronic care management code, CPT code 99490, to pay providers for delivering non-face-to-face care to Medicare patients with two or more chronic conditions.

In 2017 CMS enhanced the CCM...

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2018 Care Management Code Updates for Federally Qualified Health Centers and Rural Health Centers

Posted by DeAnn Dennis on Wed, Jan 03, 2018 @ 07:57 AM

Overview - Care Management Updates:

On November 15, the final rule of the Medicare 2018 Physician Fee Schedule was published. The updates include new billing codes and increased reimbursement for Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) when certain care management services are furnished. Beginning on January 1, 2018, two new billing codes present RHCs and FQHCs with the opportunity to receive higher reimbursement for providing Chronic Care Management (CCM),...

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2017 Update to Medicare CCM Program: 3 New Billing Codes and Simplified Requirements

Posted by DeAnn Dennis on Thu, Apr 13, 2017 @ 04:37 PM

CCM Program Enhancement Overview:

If you are currently offering Chronic Care Management services to your patients, or thinking about starting a CCM program in 2017, CMS has given you more financial incentive to do so, in the form of 3 new billing codes.  And to make the program easier to implement and manage, CMS has also streamlined service and reporting requirements.

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Three ways the Trump election may affect Transitional Care Management (TCM) and Chronic Care Management (CCM) Programs

Posted by DeAnn Dennis on Thu, Dec 08, 2016 @ 11:49 AM

The impact of Donald Trump’s election on the healthcare landscape is beginning to take shape.  Along with his election, the Republican Party has retained control of both houses of Congress and a large majority of state legislatures and governorships. 

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5 Reasons Why Now is the Best Time to Start a Chronic Care Management (CCM) Program

Posted by DeAnn Dennis on Tue, Nov 22, 2016 @ 01:18 PM

Medical Economics has a nice summary of the adoption status of the new CPT code (99490) for Chronic Care Management (CCM) launched by the Center for Medicare and Medicaid Services (CMS) almost 2 years ago. Despite the excitement of finally receiving reimbursement for a service that most practices provide for free, only 100,000 patients have been enrolled out of 35 million potentially eligible Medicare patients. The article explores why adoption has been slow, and reasons why starting a CCM...

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Taking Care of Patients with Chronic Conditions

Posted by Yehuda Bechar on Mon, Jun 07, 2010 @ 04:12 PM

First lets define "chronic condition". There are many definitions of  "chronic condition", some more expansive than others. I would characterize it as any condition that requires ongoing adjustments by the affected person and interactions with the health care system.As I mentioned on a previous blog (Chronic Disease Management and Adverse Drug Events) the care of patients with chronic conditions needs to be improved and streamlined.Some deficiencies that exist today include: • Rushed...
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