Medicare Compliance & Reimbursement

Over the last year, the output of programs and initiatives from CMS and the CMS Innovation Center like mandatory cardiac bundles, CPC+, and an expansion of the Medicare Diabetes Prevention Program point to one thing — increased funds and interest in managing chronic diseases.

Now Medicare is making a push to raise awareness of its Chronic Care Management (CCM) services, and is providing educational tools that may help you secure more reimbursement for these patients.

“Two-thirds of Medicare beneficiaries have two or more chronic conditions, and one-third have four or more chronic conditions,” the CMS says in a release.

“Many health professionals are providing these patients with chronic care management, non-face-to-face services such as reviewing test results or coordinating with other providers, but are not aware of the separate payments under the Medicare Physician Fee Schedule and are not receiving the full separate payments that are now available for CCM services under Medicare Part B.”

New tools that you and your staff can utilize include a toolkit to help providers implement CCM; a toolkit to help raise awareness of the program; and patient education resources on CCM. To order the new resources at no cost, as well as to learn more about CCM, visit go.cms.gov/ccm.