Chronic Care Management

Chronic Care Management

Are you benefitting adequately for the chronic care management you provide?

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If your practice is providing chronic care management to Medicare beneficiaries with one or more chronic conditions, you may be providing primary care but not being adequately compensated for it.

Cronic Care ManagementOne way to estimate the possible total is to multiply 36 million Medicare patients with two or more chronic conditions by roughly $42 dollars per month. CMS will pay for 20-minute consults and then multiply that by 12 months to arrive at: $17.2 billion every year Chronic diseases and conditions—such as heart disease, stroke, cancer, diabetes, obesity, arthritis—are among the most common, costly, and preventable of all health problems.

In the past, Medicare has only approved incentive payment for non-face-to-face chronic care management, CCM (such as medication reconciliation, coordination among providers, arrangements for social services, remote patient monitoring) — if the services were billed as part of face-to-face evaluation and management (E&M) services. As of January 1, 2015, that situation has changed. Medicare will now compensate providers for CCM under CPT 99490.

This results in patients with chronic conditions, very often left to manage their conditions by themselves between office visits. This asymmetrical method of chronic disease management leads to high costs of health management, leading to emergency room visits, hospitalization as well as deaths.

Chronic care management services is defined as at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements:

Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient.
Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.
Comprehensive care plan established, implemented, revised, or monitored.

OmniMD gives you the tools to adequately implement, track and bill for your monthly CCM activities:

OmniMD has helped over 12,000 healthcare professionals improve their clinical operations, patient care and financial strength through our solutions and services. Let us help you “take back your practice, patients and profits” by providing you with the tools to effectively manage, chart and bill for chronic care.

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Capture lost revenue from CCM

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In the past, Medicare has only approved incentive payment for non-face-to-face… Read More