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October 23, 2017 | A Look at Medicare’s CCM Program

In January 2015, Medicare set forth the Chronic Care Management (CCM) program. It reimburses physicians for 20 minutes of non-face-to-face care every month to patients with two or more chronic conditions.

With over 69% of Medicare patients having two or more chronic conditions, the cost of care for patients, physicians and the government is enormous. In fact, the estimated cost of treatment for just the top seven most prevalent chronic diseases is $1.3 trillion.
— Wellbox Whitepaper: New Options in Chronic Care Management

The Medicare CCM Program

Medicare reimburses physicians and sees this care as less expensive and leading to less costly interventions. This news came as a pleasant surprise to some physicians. They were now going to be paid for the added care they had always provided. For others, this reimbursement under CPT code 99490 allows them to earn more revenue while providing an additional service to many of their patients.

However, the program requires trained medical professionals to conduct and document the calls. It also requires knowledge of proper documentation and billing for the service. This is why many decide to outsource the service. It provides their patients with personalized, additional care for their chronic conditions while still increasing their revenue year-over-year.

The following infographic depicts the Medicare CCM program as well as the potential revenue a practice can make each year by outsourcing Chronic Care Management.