What are the CCM codes?

What are the CCM codes?

Use of CPT® codes 99490, 99439, 99487, 99489, 99491 and HCPCS code G0506. Chronic care management services are service provided to patients who have medical and/or psychosocial needs requiring establishing, implanting and monitoring a care plan.

What is the CPT code for chronic care management?

CPT code – 99487 complex CCM is a 60-minute timed service provided by clinical staff to substantially revise or establish comprehensive care plan that involves moderate- to high-complexity medical decision making.

What is considered chronic care management?

Chronic care management is a specific care management service that provides coverage for patients with two or more chronic conditions for a continuous relationship with their care team. Under CCM, the patient’s care team can bill for time spent managing the patients’ conditions.

Can CCM and TCM be billed together?

2) CCM can be billed concurrently with TCM Previously, CCM time couldn’t be billed in the same month for a patient that you are already billing TCM time for. This change now allows you to bill for both TCM and CCM in the same month for the same patient when “reasonable and necessary”.

What is Medicare CCM?

Medicare Chronic Care Management (CCM) helps members with chronic conditions receive coordinated care and reach their treatment goals. A chronic condition is any condition that lasts for at least a year and limits your daily activities or requires regular medical care.

What is the difference between 99490 and 99491?

Under CPT 99490, clinical staff supervised by a doctor can perform CCM for billing purposes. The new code 99491 compensates doctors and nurse practitioners for their time spent on CCM related care and requires them to provide such care personally. It also requires a minimum of 30 minutes a month.

How do you bill for chronic care management?

CPT 99439, to be used with CPT 99490, is defined as non-complex, chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other QHP, per calendar month. For health centers, CPT 99439 will crosswalk to G0511.

What conditions are considered chronic by CMS?

CMS IDENTIFIES 15 CHRONIC CONDITIONS FOR MEDICARE

• Chronic alcohol and other drug dependence.
• Certain autoimmune disorders.
• Cancer excluding pre-cancer conditions.
• Certain cardiovascular disorders.
• Chronic heart failure.
• Dementia.
• Diabetes mellitus.
• End-stage liver disease.

What are examples of chronic care?

Some chronic conditions may eventually be resolved through medication, surgery, physical therapy, or other treatment options; but until then, ongoing care must be taken….A few examples of chronic conditions include:

• Arthritis.
• Heart disease.
• COPD.
• Asthma.
• Diabetes.
• Osteoporosis.
• Cancer.

Can you bill CCM and RPM?

As well, it is important that when billing for both PCM and RPM, you record billable time for each program. So, for PCM you would record 30 minutes and then an additional 20 minutes for RPM.

What is the difference between TCM and CCM?

The real differentiator between TCM and CCM is the face-to-face visit requirement. This requires that either the patient come into the physician’s office/facility or that the physician visits the patient wherever they reside.

Does Medicare cover CCM?

CCM is covered under Medicare Part B. This means that Medicare will pay 80 percent of the cost of service. You’ll be responsible for a coinsurance payment of 20 percent.