Chronic Care Management (CCM) at Evrostos Health strives to promote better health outcomes while reducing overall health care costs. Because we understand that, as we grow older, the risk for developing chronic conditions increases. While a lot of factors may impact in developing these conditions or issues, it is important to understand that managing these conditions is significant to our existence.
Whether physical or mental, your patients’ chronic conditions can be managed more effectively, while also improving communication among other treating clinicians. Our goal for Chronic care is to improve the quality of life for the people who are struggling to manage multiple chronic conditions in their daily life. With support from our care managers and chronic conditions management services, your patients are likely to achieve their health goals.
What is Chronic Care Management?
Chronic care management refers to the care provided by medical professionals to patients who have two or more chronic diseases and conditions that lasts a year or more, requires ongoing medical attention or limits the activities of daily life. It includes both physical and mental conditions.
Chronic Care Management is a critical component of primary care that offers better health for patients. These services are furnished for Medicare patients with two or more chronic conditions who are at significant risk of death, acute exacerbation/decompensation, or functional decline, while allowing healthcare professionals to be reimbursed for the time and resources used to manage the patients’ health.
Chronic care management refers to the care provided by medical professionals to patients who have two or more chronic diseases and conditions that lasts a year or more, requires ongoing medical attention or limits the activities of daily life. It includes both physical and mental conditions.
Chronic Care Management is a critical component of primary care that offers better health for patients. These services are furnished for Medicare patients with two or more chronic conditions who are at significant risk of death, acute exacerbation/decompensation, or functional decline, while allowing healthcare professionals to be reimbursed for the time and resources used to manage the patients’ health.
Only one physician or other qualified health care professional who assumes the care management role for a beneficiary can bill for providing CCM services to that patient in a given calendar month. While services may be provided by a clinical staff, the service must be billed under one of the following:
Physician
Clinical nurse specialist (CNS)
Nurse practitioner (NP)
Physician assistant (PA)
Certified nurse midwife
Non-physicians must legally be authorized and qualified to provide CCM in the state in which the services are furnished.
What is a CCM-Eligible Chronic Condition?
Any condition that meets the Medicare criteria can qualify a patient for CCM. Some of the most common examples include:
Alzheimer’s disease
Arthritis
Asthma
Autism
Cancer
Cardiovascular disease
Dementia
Depression
Diabetes
Heart disease
High blood pressure
Hypertension
HIV/AIDS
Lupus
Multiple sclerosis
2022 Medicare Physician Fee Schedule Final Rule: Increased Reimbursement for Care Management Services
CPT 99490 ($64.03)– Initial 20 minutes, clinical staff.
CPT 99439 ($48.45)– Subsequent 20 minutes, clinical staff.
CPT 99491 ($86.18) – Initial 30 minutes, physician or non-physician practitioner (NPP)
CPT 99437 ($61.26) – Subsequent 30 minutes, physician or NPP
Additional source – chroniccaremanagement.pdf