The initial program rollout at McLaren Macomb hospital provides care management services to patients who have visited the emergency room and are COVID-19 positive or presumed positive but are not currently critical enough for hospital admission. Under the program, nurses at GAP reach out to patients within 12 hours of discharge to determine their current stability, and provide a time frame in which a local ambulance company will visit the patient’s home to complete a baseline assessment and...

Updates for Medicare Diabetes Prevention Program Expanded Model:

With the intent of lowering the rate of progression to Type II diabetes and improving overall health, the CMS has finalized the Medicare Diabetes Prevention Program (MDPP) expanded model, which will allow qualified providers to begin furnishing MDPP services this year.

Care Management Programs Overview:

Beginning in 2013, the Centers for Medicare and Medicaid Services introduced transition of care management (TCM), reimbursing providers for helping their patients with the transition from hospital to home.  Following the introduction of TCM; in 2015 CMS introduced the original chronic care management code, CPT code 99490, to pay providers for delivering non-face-to-face care to Medicare patients with two or more chronic conditions.

In 2017 CMS enhanced the CCM...

Overview - Care Management Updates:

On November 15, the final rule of the Medicare 2018 Physician Fee Schedule was published. The updates include new billing codes and increased reimbursement for Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) when certain care management services are furnished. Beginning on January 1, 2018, two new billing codes present RHCs and FQHCs with the opportunity to receive higher reimbursement for providing Chronic Care Management (CCM),...