Chronic Care Management

Chronic Care Management

Care management is one of the critical components of primary care that contributes to better health for individuals and reduced health care expenditures.

The Centers for Medicare & Medicaid Services (CMS) introduced a non-visit-based payment code for chronic care management (CCM) services on Jan. 1, 2015. CCM services are provided to Medicare beneficiaries with two or more chronic conditions that are expected to last at least 12 months or until death. This CCM payment method enables eligible clinicians to receive reimbursement when providing these Medicare beneficiaries with 20 minutes of non-face-to-face care coordination services a month.

According to CMS, only 100,000 Medicare beneficiaries are receiving these valuable CCM services, despite 35 million being eligible for it, based on billing records as of October 2015. To help increase the number of practitioners effectively implementing and providing CCM services to their patients, the TMF Quality Innovation Network Quality Improvement Organization, is providing technical assistance and support to physicians, nurse practitioners and physician assistants in Arkansas, Missouri, Oklahoma and Texas.

Through the Chronic Care Management Network, TMF works with clinicians to identify eligible patients and coordinate CCM with processes such as billing, documentation and service tracking tools. TMF also provides educational tools, resources and events to support clinicians’ CCM efforts.

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Chronic Care Management