Implementing CCM 99490: A Step-by-Step Guide

Implementing CCM 99490: A Step-by-Step Guide

Getting Started With Chronic Care Management

The Centers for Medicare & Medicaid Services (CMS) recognizes that chronic conditions need to be addressed differently. Treating chronic conditions requires high frequency but low complexity interventions best accomplished by non face-to-face interactions between doctors and patients. This is why CMS will now pay separately for those non-face-to-face care coordination services furnished to Medicare beneficiaries with multiple chronic conditions.

Whether your practice is trying to determine the best way to get started or you’re looking for ways to streamline your processes and drive greater efficiency out your existing program, our step-by-step guide can help. This useful tool outlines the specific steps providers should take in order to make the most of the Chronic Care Management reimbursement. It even includes a sample consent form.

Check out the four steps to practical and profitable Chronic Care Management below and then download the guide for your practice.

Step 1: Identify & Recruit Eligible Patients

Run and sort EHR reports to identify qualifying patients. Once a patient is identified, recruit them to participate in the program by sending a personalized letter, email, or other preferred communication. Download the step-by-step guide for patient recruitment tips and considerations.

Step 2: Enroll & Educate

Enrollment is done through a face-to-face physician visit where the benefits of a comprehensive care plan are discussed. It’s important to educate both patients and staff on the details and value of the program. A sample checklist and written consent form is included in the step-by-step guide.

Step 3: Engage & Activate

Develop a comprehensive chronic care management plan for the patient, and allocate at least 20 minutes a month of non-face-to-face care for a clinical staff member to assess the patient’s needs, review the recommended preventative care plan, and perform medication reconciliation with review of adherence and potential interaction. Patient outreach strategies can be found in the step-by-step guide.

Step 4: Bill for Reimbursement

CMS requires a clear audit trail for billing and reimbursement of CCM. Validate that the requirements were met for each patient, each month. A list of requirements can be found in the step-by-step guide.

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Download the full guide and share it with others in your practice.


Contact West

Whether you’re in the planning stages or working to drive greater efficiency in your Chronic Care Management program, West can help. Contact us today.