Low Utilization of Chronic Care Management Codes Seen by CMS

Coding Corner

The information provided here applies to Medicare coding. Be sure to check with your Medicare Administrative Contractor (MAC) for additional information and clarification on these and other items. You should also contact your local insurance carriers to determine if private insurers follow Medicare's lead on all coding matters.

Low Utilization of Chronic Care Management Codes Seen by CMS
According to CMS, doctors are not taking advantage of the new code for chronic care management services. American Medical Association Current Procedural Terminology (CPT) code 99490 was implemented to improve care and reduce hospital readmissions and overall costs by providing a per-patient per-month payment for non-face-to-face chronic care coordination services. According to CMS, it has received 100,000 reimbursement requests for an estimated 35 million eligible beneficiaries. Concerns have been raised by the physician community that the complexity of compliance has steered doctors away from the program.  As a result, of the intent of the code and the limited utilization to date, CMS is trying to raise awareness and interest among Medicare beneficiaries and providers. To learn more about chronic care management services visit www.cms.gov.

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