Home Health & Hospice Week

Good news: General supervision a go.

Unlike the original Chronic Care Manage-ment proposal, the final regulation gives your referring physicians some leeway on who can furnish CCM and receive payment.

Advanced Practitioners, such as nurse practitioners and physician assistants, can provide and bill for CCM services independently — but only at 85 percent of the reimbursable rate, the Centers for Medicare & Medicaid Services says in the final rule. APs can, however, receive 100 percent of the reimbursable rate if they are supervised.

Key: “Currently, any practitioner who wishes to bill in a physician’s name requires ‘direct sup-ervision’ — e.g., the physician must be available in person, on site, to assist the staff,” says Krista Tes-ke, senior analyst at The Advisory Board Com-pany. “However, CMS has made it clear that for this new chronic care management code they will instead only require ‘general supervision’ — e.g., the physician only has to be available by phone.”

The flexibility doesn’t stop there. “Unlike what was previously proposed, the clinical staff performing the CCM services do not need to be direct employees of the provider or practice,” Teske says.

“In addition, the practitioner who provides the ‘general supervision’ does not need to be the same person under whose name the chronic care management code is billed. In other words, groups can choose to outsource both the care management services and the supervision of these services to contractors,” she adds.

And any physician who performs CCM can bill for the code, not just primary care providers.