New CPT Chronic Disease Management Code 99490 Save

The new Medicare Physician Fee Schedule will allow for reimbursement for chronic care management services (CCM). This ACP Internist article reviews the new CPT code 99490 (chronic care management services) that requires at least 20 minutes of clinical staff time (physician or other qualified HCP) each month to manage patients with multiple significant medical conditions.  

CCM reporting requires the use of and electronic health record electronic that meets certification criteria for the EHR Incentive Programs and meets 2 core technology features: demographic recording, problem and medication lists, medication allergies, and a summary care record.  This EHR information must be  available 24/7 to all practitioners who are furnishing CCM service and must be shared with other physicians and HCP providing comprehensive services.  CCM must include certain elements under scope of services including continuity of care with a designated practitioner, access to care management services 24/7, management of care transitions between and amongst providers and coordination of home and ccommunity services for the beneficiary.   Lastly the patient needs to be informed and consent to his/her involvement in CCM and that the consent form be included in the medical record.  

The ACP is creating tools to assist in the future use of CCM.