New year, new code: How to get paid for chronic care management in 2015, part 3

Beginning in 2015, physicians and other qualified health care professionals will be able to separately bill Medicare for providing non-face-to-face chronic care management, or CCM, services by billing CPT code 99490. In recognizing and payment for these non-face-to-face services, the Centers for Medicare and Medicaid Services has taken an important step toward recognizing that care coordination is an essential feature of providing high-quality primary care and that important aspects of this care occur when the patient is not in the office.We described the scope of service in part 1 and health information technology requirements in part 2; however, several unanswered questions and challenges regarding the use of this new code remain. Unfortunately, CMS currently does not plan on providing any additional clarity on these issues. To the contrary, CMS staff have recently stated that they learned some lessons from the poor utilization of the transitions of care management codes (99495 and 99496), so they intentionally placed very few requirements on — and thus, provided very little guidance to — practices to facilitate widespread use of the CCM code.