Care Management Program Implementation, Enrollment and Monthly Management

How to implement CCM/Care Management Program in your practice

  • CCM
  • Transitional care management
  • BHI management
  • RPM
  • PCM

Selecting the right CCM/Care Management third party vendor


CCM Program Information

Chronic care management (CCM) services are eligible for Medicare reimbursement to physicians and other qualified health care practitioners (OQHPs), such as nurse practitioners, clinical nurse specialists, certified nurse midwives and physician assistants. Beginning back on January 1, 2015, a per beneficiary, once per calendar month fee is payable for qualifying non-face-to-face care coordination and care management services of at least twenty (20) minutes of clinical staff time provided or directed by the physician or OQHPs to eligible Medicare beneficiaries. 2020 proposed changes and updates to CMS program include additional 20 minutes (total 40 min) for clinical staff time prior to obtaining medical decision making. CMS also proposed new PCM codes for patients with only one chronic condition that include some special requirements for qualifications. Additionally, there are other new proposed updates to current care management codes that include the care plan and updates for FQHC’s. CMS updates should be available by Thanksgiving 2019.


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