High-quality care and efficiency — Centers for Medicare and Medicaid Services (CMS) emphasized these two points with the release of its 2015 Medicare Physician Fee Schedule. Physicians (regardless of specialty), advanced practice registered nurses, physician assistants, clinical nurse specialists, and certified nurse midwives (or the provider to which such individual has reassigned his/her billing rights) are eligible to bill Medicare for Chronic Care Management (CCM) beginning in 2015.
With a known shortage of primary care access in the United States, national telemedicine platforms such as Connect4MD become important in filling a care coordination gap, and a very useful advancement in managing population transitional care and chronic care.
“Health care is changing, and part of delivery system reform is recognizing this and making sure payment systems account for these changes,” said CMS principal deputy administrator Jonathan Blum in a written statement. “We believe that successful efforts to improve chronic care management for these patients could improve the quality of care while simultaneously decreasing costs, through reductions in hospitalizations, use of post-acute care services, and emergency department visits.”
In the final rule, CMS has adopted CPT 99490 for Medicare CCM services, which is defined in the CPT professional codebook as follows:
Chronic care management services, 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/decompensating, or functional decline, comprehensive care plan established, implemented, revised, or monitored.
Connect 4 Medical clinical and technology experts support a physician in achieving the five capabilities your practice will need to perform the above: 1) Evaluation of your EHR for specified purposes, 2) a real-time electronic care plan, 3) Ensure beneficiary access to care, 4) Facilitate transitions of care, and 5) Coordinate care. We enhance your intimate relationship with the patient, and achieve ability to bill the CCM.
The national average reimbursement will be $40.39 per beneficiary per calendar month and, Connect 4 Medical offers providers a connectivity between fee-for-service and value-based reimbursement. By developing and implementing a CCM program, you will grow internal processes and critical skill sets for population health management, all the while receiving fee-for-service payment to support those activities.
For more information on integrating chronic care management or telemedicine inside your organization, email firstname.lastname@example.org or call (800) 840-1360.