Medical Economics has a nice summary of the adoption status of the new CPT code (99490) for Chronic Care Management (CCM) launched by the Center for Medicare and Medicaid Services (CMS) almost 2 years ago. Despite the excitement of finally receiving reimbursement for a service that most practices provide for free, only 100,000 patients have been enrolled out of 35 million potentially eligible Medicare patients. The article explores why adoption has been slow, and reasons why starting a CCM program now is good for your practice today and for the future as we transition to a value-based reimbursement model.
- Even small practices can earn up to $240,000 annually by enrolling their Medicare patients in the CCM program.
- In a few years, CCM will become mandatory, as volume-based, fee-for-service reimbursement is replaced with value-based formulas.
- Only one physician can be a team leader for CCM services for a patient, so enrolling patients in a CCM program now can prevent your practice from losing patients if this role is assigned to other providers.
- Performance in 2017 will determine a provider’s reimbursement in the value-based model in 2019. Payment under the new model will be determined for providers that can demonstrate quality, advancing care information, and clinical practice improvement in 2017. Establishing a robust CCM program now will better position you for these changes.
- CMS allows practices to remove the administrative and development headaches of a CCM program by outsourcing these services to outside vendors. This will be help even smaller practices that feel that they are not ready to launch their own CCM program.
As mentioned in the article, a CCM program for your practice is a not just “nice to have” but a “must have” for your practice not only for revenue enhancement now, but for your future.
Below is the link to the full article:
Interested in learning more? Download our whitepaper here: Understanding Medicare TCM and CCM Programs
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