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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TCD Medical Offers a Bridge in Behavioral Care; Linking Patients With Addiction or Mental Health Issues to Specialists

Posted by DeAnn Dennis on Thu, Aug 02, 2018 @ 11:50 AM

TCD Medical and Behavioral Health Integration:

An estimated one third of patients being treated by a primary care doctor are also suffering from a mental health condition or substance abuse disorder. Primary care doctors may feel overwhelmed, or that their practice is not equipped to handle such specialized care. However, due to limited access issues, it may take three to sixth months to make an appointment with a behavioral health specialist. A partner of Avicenna, the Amherst-based TCD Medical

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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.

Medicare's...

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2018 Updates to the Medicare Diabetes Prevention Program

Posted by DeAnn Dennis on Thu, May 24, 2018 @ 02:43 PM

Updates for Medicare Diabetes Prevention Program Expanded Model:

With the intent of lowering the rate of progression to Type II diabetes and improving overall health, the CMS has finalized the Medicare Diabetes Prevention Program (MDPP) expanded model, which will allow qualified providers to begin furnishing MDPP services this year.

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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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