Chronic Care Management
CCM at a glance
117 million Americans have one or more chronic health conditions. That’s half of the adult population of the U.S.
Medicare began allowing physicians to bill for chronic care management (CCM) in 2015.
CMS specifies that the code must be billed for “non-face-time follow-up care outside the office” each month.
Whitepaper: New Options in Chronic Care Management
This whitepaper discusses why the CCM program was created, which patients qualify for the program and its benefits to patients and physicians’ practices.
Chronic diseases and conditions — like heart disease, stroke, cancer, diabetes, obesity, and arthritis — are among the most common and costly health problems.
2/3 of Medicare beneficiaries have 2 or more chronic conditions.
Patients with multiple chronic conditions often visit multiple providers in different organizations, leading to duplication and conflicts in Care Plans.
What CCM does for practices
- It reimburses physician practices for providing ongoing care to Medicare patients with chronic conditions.
- It helps providers proactively manage patient health rather than only treating disease and illness.
- It brings a systematic approach to defining and managing a patient’s Care Plan.
- It organizes care coordination under one provider.
What CCM does for patients
- It provides patients with a care coordinator that closely monitors their health.
- It helps patients better understand their Care Plan.
- It develops meaningful relationships between providers and patients.
- It offers added care for free for most patients.
Understanding the Requirements of Code 99490
This code is specific to Chronic Care Management and is the reimbursement of chronic care services for patients with 2 or more chronic conditions.
To be reimbursed for such care, practices must:
Conduct at least 20 minutes of non face-to-face care
Contact each eligible patient every month
Establish, implement, revise or monitor a comprehensive care plan
What’s involved in CCM
Structured Data Recording
In a Meaningful Use I or II certified EHR
Patient-centered, accessible and sharable electronically where appropriate
24/7 Access to Care
Continuity of care with designated care team member and enhanced communication opportunities
Systematic and documented patient contact, medication reconciliation and care coordination
The Challenge of CCM
"Many providers struggle to balance the 24/7 needs of chronically ill patients within the huge scope of their duties, unable to devote staff to the full-time job of communicating with and creating care plans for these patients outside of face-to-face office visits."
— Michelle Li, MD
That’s why we’re here. We make CCM effective for your patients and simple for your practice.
You can do it yourself, or do it effortlessly with Wellbox.