Chronic care management (CCM) services are generally non-face-to-face services provided to Medicare beneficiaries
who have multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the
patient
Chronic care management includes a comprehensive care plan that lists a
patient’s health problems and goals, other providers, medications,
community services, and other information about a patient’s health.
Proper Telehealth’s dedicated team of licensed medical professionals serves
as an extension of your care team, providing 20 minutes of virtual care each
month to qualifying patients, and an additional time for more complex CCM.
All patient interactions are documented in each clinic’s EMR
FAQs
Chronic Care Management (CCM)
Billing Codes
Requirements for 99490 (Non Complex CCM):
Two or more chronic conditions expected to last at least 12 months (or until the death of the patient)
- Patient consent (verbal or signed)
- Personalized care plan in a certified EHR and a copy provided to patient
- 24/7 patient access to a member of the care team for urgent needs
- Enhanced nonfacetoface communication between patient and care team
- Management of care transitions
- At least 20 minutes of clinical staff time per calendar month spent on nonfacetoface CCM services directed by physician or other qualified health care professional
- CCM services provided by a physician or other qualified health care professional are reported using CPT code 99491 and require at least 30 minutes of personal time spent in care management activities
What are the requirements for patient qualification?
- Two or more chronic conditions expected to last at least 12 months (or until the death of the patient)
- Patient consent (verbal or signed)
- Personalized care plan in a certified EHR and a copy provided to patient
- 24/7 patient access to a member of the care team for urgent needs
- Enhanced nonfacetoface communication between patient and care team
- Management of care transitions
- At least 20 minutes of clinical staff time per calendar month spent on nonface other qualified health care professional
- CCM services directed by physician or CCM services provided by a physician or other qualified health care professional are reported using CPT code 99491 and require at least 30 minutes of personal time spent in care management activities
What documentation is required?
CCM services that must be documented in the electronic health record (EHR). Covered services include, but are not limited to:
- Management of chronic conditions
- Management of referrals to other providers
- Management of prescriptions
- Ongoing review of patient status