Beginning on January 1, 2015, Medicare began paying for non face-to-face services for Chronic Care Management (CCM). Physicians can be paid via CPT Code 99490 for time invested outside of regular office visits, including phone, text or care coordination activities, to manage their patients with chronic conditions. In order to be eligible for Chronic Care Management services, the patient must meet the following criteria:
2+ chronic conditions expected to last at least 12 months or until death of the patient.
Conditions place the patient at significant risk of death, acute decompensation, or functional decline.
For patients not seen for more than a year, participation must be initiated during an AWV, IPPE, or E/M visit.
Summary of key program elements
Only one provider can bill per patient per month.
20 minutes of non-face-to-face, comprehensive care management for chronic conditions each month.
Structured recording of patient information including demographics, problems, medications, and medication allergies using certified EHR technology.
Create and monitor an electronic comprehensive patient-centered care plan; share electronically and timely with all providers involved in the patient’s care.
24/7 access to healthcare professionals in the practice to address urgent needs.
Management of care transitions between health care providers and settings, including referrals; timely exchange of clinical summaries with other providers.
Coordination with home and community based clinical service providers.
Asynchronous communication (in addition to telephone).