Chronic diseases such as obesity, heart disease, diabetes, hypertension, mental health, congestive heart failure and COPD are among the most common and treatable health problems in the United States. CMS estimates that 66% of Medicare beneficiaries have two or more chronic conditions. If 50% of eligible patients received chronic care management services for a year, this would result in over $10 billion in additional Medicare payments to provider organizations. If a single provider bills CCM services for an average of 200 patients in his/her practice for 12 months, this would generate a little over $100,000 annually. Practices with large Medicare populations could see substantially higher levels of reimbursement.
Medicare has looked at this model closely. They anticipate that comprehensive CCM services will lead to a marked reduction in healthcare costs and to better outcomes.
Eligible providers listed below are able to oversee and bill Medicare for CCM services. Under an exception to the Medicare "Incident to" policy, providers do not need to be physically present in the facility when a clinical staff member is providing CCM services. Thus a certified medical assistant can provide CCM services to patients from any location and after hours.
Any Provider Billing For CCM Is Required To Use TechnologyThe following providers are eligible to bill for CCM services:
Only One Provider Per Patient May Bill Per Calendar Month.
The provider must be using a certified electronic health record (EHR) product that meets current requirements for the Meaningful Use of Certified EHR technology incentive program