The new CPM bundled payment covers integrated multimodal pain care that may include certain elements such as
diagnosis, a person-centered plan of care, care coordination, medication management, and other aspects of pain care.
As part of its ongoing effort to expand access to evidence-based treatments
for acute and chronic pain and to improve the care experience for
individuals suffering from pain, CMS introduced new CPT codes for Chronic
Pain Management (“CPM”) services in the 2023 Medicare Physician Fee
Schedule Final Rule
The new CPM bundled payment covers integrated multimodal pain care that
may include certain elements such as diagnosis, a person-centered plan of
care, care coordination, medication management, and other aspects of pain
care
FAQs
Chronic Pain Management (CPM)
- G3002, “Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person a centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling; any necessary chronic pain related crisis care; and ongoing communication and care coordination between relevant practitioners furnishing e.g. physical therapy and occupational therapy, complementary and integrative approaches, and communitybased care, as appropriate. Required initial facetoface visit at least 30 minutes provided by a physician or other qualified health professional; first 30 minutes personally provided by physician or other qualified health care professional, per calendar month. (When using G3002, 30 minutes must be met or exceeded.)”
- G3003, “Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month (list separately in addition to code for G3002). (When using G3003, 15 minutes must be met or exceeded.)”
Chronic pain is reclassified in ICD11. Under this new classification, chronic pain is defined as ‘pain that persists or recurs more than 3 months,’ as it has been previously. The classification goes even further to differentiate types of pain. Pain can the sole or a leading complaint, needing special treatment and care.
Other subgroups specify that pain may be secondary to an underlying disease. For instance, there can be chronic cancer for berelated pain, chronic neuropathic pain, chronic secondary visceral pain, and chronic secondary headache and orofacial pain, to name a few categories
CPM services can be billed by a physician, nurse practitioner, physician assistant, or eligible qualified health care profess al. However, the initial visit under HCPCS Code G3002 must be in person where both individuals are in a clinical setting such as ion primary care practitioner’s office or another applicable setting. Patient consent for these services should be obtained and documented in the record.