Is Medicare’s Chronic Care Management Program for You?

Interested in the possibility of getting paid as much as $75,000, or even more, for something you already more or less do?

Medicare now pays separately for chronic care management (CCM) services under the Medicare physician fee schedule. CCM services are non-face-to-face activities you or your clinical staff perform to manage and coordinate the care of your patients. Perhaps you’ve long provided these services at your own expense. But now, Medicare will pay you for your time on a monthly basis.

To help you decide if this new opportunity is right for your practice, TMA created a new resource center outlining the details.

How do you get started? To initiate the services, Medicare requires that you obtain a patient’s informed and written consent during a face-to-face visit, such as during an initial preventive physician exam, annual wellness visit, or comprehensive evaluation and management visit billed separately. Sample consent forms are available in the resource center

Among other elements and requirements, practices must be able to:  

  • Provide care management services, manage care transitions, and coordinate care;
  • Use structured data recording via certified electronic health record (EHR) technology;
  • Create and maintain a comprehensive, patient-centered care plan that is electronically available at all times to you or a designated member of the care team involved in care management services;
  • Ensure 24/7 access to care management services that gives patients and caregivers a way to make timely contact with you or a designated member of the care team who has access to the patient’s electronic care plan to address urgent needs related to their chronic conditions;
  • Ensure a patient’s continuity of care with you or a designated member of the care team through successive routine appointments; and
  • Provide enhanced opportunities for patient and caregiver communication with you or a designated member of the care team through telephone or other HIPAA-compliant, non-face-to-face methods.

Visit the new TMA Chronic Care Management Resource Center, and read about Texas physicians who have implemented CCM services in their practices in Texas Medicine.

Published Sept. 9, 2015

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Last Updated On

May 13, 2016