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CCM CPT 99490

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Tony Fanelli
Tony Fanelli

To provide chronic care management (CCM) services and bill Medicare, several requirements must be met: 1) Written consent from the beneficiary is required before services begin. 2) The care plan must be electronically accessible 24/7 to all providers on the care team, as well as the beneficiary. 3) At least 20 minutes per month of non face-to-face care coordination is required, including tracking time spent and services provided.

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caresync Obtain Beneficiary’s Written Consent r The billing practitioner must explain the program and secure the beneficiary’s written consent before CCM services can begin All Providers Have Access to the Patient’s’ Care Plan r No fax allowed. r Your EMR or HIE must make the Comprehensive Care Plan electronically accessible, 24/7, to all of the patients’ healthcare providers. Share A Comprehensive Care Plan r You must create and maintain a care plan from all providers and electronically share it with the entire care team. No fax allowed. r You must provide the patient and their family with 24/7 electronic access or a paper copy of the comprehensive Care Plan - most EMRs do not provide this. Manage Medications r You must provide medication reconciliation, adherence, potential interactions, and maintain a list of current medications and allergies r You must oversee & track the patient’s self- management of medications Time Tracking: 20 minutes non face- to-face r You must spend a minimum of 20 minutes of documented time per month r You must record the start and stop time, who performed the services, and a short description of what services were provided r 500 CCM patients will require TWO full-time licensed clinical staff Post-Discharge Transitional Care Management (TCM) r You must have the capability to follow up with the beneficiary after an ER visit, provide any necessary TCM services, and coordinate referrals to other healthcare providers. Obtain confirmation from your technology vendor r You are required to use technology for electronic access to Care Plans by patients and all of the patient’s providers. r You must be certain that your EMR vendor provides the documentation for required services to bill Medicare for CCM Are you prepared to meet the requirements of 99490? caresync 813.658.3749 www.caresync.com sales@caresync.com phone website email

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CCM CPT 99490

  • 1. caresync Obtain Beneficiary’s Written Consent r The billing practitioner must explain the program and secure the beneficiary’s written consent before CCM services can begin All Providers Have Access to the Patient’s’ Care Plan r No fax allowed. r Your EMR or HIE must make the Comprehensive Care Plan electronically accessible, 24/7, to all of the patients’ healthcare providers. Share A Comprehensive Care Plan r You must create and maintain a care plan from all providers and electronically share it with the entire care team. No fax allowed. r You must provide the patient and their family with 24/7 electronic access or a paper copy of the comprehensive Care Plan - most EMRs do not provide this. Manage Medications r You must provide medication reconciliation, adherence, potential interactions, and maintain a list of current medications and allergies r You must oversee & track the patient’s self- management of medications Time Tracking: 20 minutes non face- to-face r You must spend a minimum of 20 minutes of documented time per month r You must record the start and stop time, who performed the services, and a short description of what services were provided r 500 CCM patients will require TWO full-time licensed clinical staff Post-Discharge Transitional Care Management (TCM) r You must have the capability to follow up with the beneficiary after an ER visit, provide any necessary TCM services, and coordinate referrals to other healthcare providers. Obtain confirmation from your technology vendor r You are required to use technology for electronic access to Care Plans by patients and all of the patient’s providers. r You must be certain that your EMR vendor provides the documentation for required services to bill Medicare for CCM Are you prepared to meet the requirements of 99490? caresync 813.658.3749 www.caresync.com sales@caresync.com phone website email