White Paper
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With CCM being such a tremendous opportunity to help your most at-risk patients while also boosting your Medicare reimbursement, perhaps a better question is, “Why wouldn’t you ...?” Chronic Care Management (CCM) services are personal, remote interactions done outside of and between routine office visits. Initiated by Medicare in 2015, this collection of services is performed by ancillary staff under general supervision...
In recent years, CMS has finalized payment for seven remote physiologic monitoring (RPM) codes. In response to stakeholder questions about RPM, CMS clarified in the CY 2021 PFS Final Rule, its payment policies related to the RPM services described by CPT codes 99453, 99454, 99091, 99457, and 99458. In addition, they finalized as permanent policy, two modifications to RPM services that were...
Now that we appreciate the numerous benefits of starting a CCM program, both from the standpoint of patient care and reimbursement, as well as realizing some of the reasons behind the hesitation by providers to initiate CCM, let’s first discuss the “nuts and bolts” of how to execute a program. Then, we’ll address practical methods to overcome the perceived operational obstacles. In...
Previously, we’ve discussed the numerous benefits of incorporating Chronic Care Management (CCM) into a primary care practice. Intended to help care for the sickest and most challenging Medicare patients, those with two or more significant chronic conditions which represents up to 80% of this population, the ability to regularly and proactively reach this subset of patients between office visits, supporting and motivating...
Some providers are understandably troubled by the recently released CMS Physician Fee Schedule Final Rule. After all, the final conversion factor has settled at $32.41, a decrease of ≅ 10% from the 2020 conversion factor of $36.09. This is due to the budget neutrality requirement as required by law to account for and offset a number of RVU increases. But while the...