Primary Care Physicians Could Soon Bill for Chronic Care Management Services Separately

If the 2015 Medicare Physician Fee Schedule proposed by the Centers for Medicare & Medicaid Services (CMS) is adopted, primary care physicians would be able to bill separately for chronic care management (CCM) services beginning next year, according to a CMS fact sheet and Medical Economics report on the proposed rule.

CMS defines CCM services as including regular development and revision of a plan of care, communication with other treating health professionals and medication management.

In last year's final rule, CMS established policy to make separate payment for non-face-to-face CCM services for Medicare beneficiaries who have multiple, significant chronic conditions

This year's proposed rule addresses three aspects of CCM services:

  • Proposed payment rate of $41.92 for the CCM code that can be billed no more frequently than once per month per qualified patient.
  • Proposed greater flexibility in the supervision of clinical staff providing CCM services.
  • Proposed standards for electronic health records.

CMS noted that it is not proposing to establish separate standards that practitioners and practices furnishing this service would have to meet, as was indicated last year.

To learn more about how the proposed rule could affect family physicians, read the American Academy of Family Physicians' highlights of the proposed schedule and 12-page summary of payment provisions (pdf).

If you are struggling with primary care billing, contact PGM Billing to learn more about its internal and family medicine billing services, and how outsourcing your billing may be the solution your practice needs.


X