The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH), in conjunction with the Federal Office of Rural Health Policy at the Health Resources and Service Administration (HRSA), recently introduced an initiative to provide support for, educate about, and raise awareness of Chronic Care Management and the many benefits this program provides to both physicians and patients – especially in underserved communities.
Since 2015, physicians haven been able to provide CCM services to Medicare beneficiaries with multiple chronic diseases for additional payment (read more about billing for Chronic Care Management here), however the vast majority of physicians qualified to provide this service simply don’t know about it. According to CMS, two-thirds of Medicare beneficiaries have two or more chronic conditions and one-third have four or more chronic conditions. The fact that many healthcare providers are already providing non-face-to-face services for these patients, but are unaware that they can bill for CCM (CPT code 99490) for full, separate payments to supplement their revenue, adds up to some pretty significant lost opportunities.
This CCM initiative is called Connected Care and will offer resources to help educate patients and provide information for healthcare professionals. The effort is indicative of how underutilized the CCM program is nationwide, across the physician community — versus how much potential lies in it for both practices and an underprivileged patient population.
Armed with information and education about CCM, as well as with the right tools, this revenue opportunity becomes a no-brainer for providers who are already coordinating care for Medicare patients with two or more chronic conditions, but who aren’t yet getting paid for the extra work. The key is to choose software that makes billing for CPT Code 99490 easy, organizes your patient population, and automates tasks and reminders. The built-in, Chronic Care Management module from MediTouch is precisely that tool.
We can also match you with a care coordination service that will work with your practice every step of the way to exceed Medicare’s requirements for Chronic Care Management by working with you on developing care plans, providing manpower and any other guidance you may need. Partnering with a service like this will position you for positive payment adjustments from value-based initiatives and prepare you for the move to value-based care.