Face-to-Face Enrollment for Chronic Care Management
Patients with two or more chronic conditions can be enrolled in Chronic Care Management (CCM) during a qualifying face-to-face visit with the billing provider. During this time the patient should sign a CCM consent form for the provider and their clinical staff to start rendering 20 minutes of CCM services per month and bill for CPT 99490. This initiating visit and extensive assessment can bill billed under G0506.
New Rules for 2017 Enrollment for Chronic Care Management
However, as of January 1, 2017, Medicare no longer requires a face-to-face visit for all patients or a signed consent form for enrollment. Instead, only new patients and patients who have not had a qualifying visit within a year prior to commencement of CCM must have an initiating visit. Also, CMS now allows for verbal consent, but it must still be documented in the medical record and disclaimers must still be given to the patient.
With this change, any patient who has been seen by a provider for a qualifying visit within the previous twelve months can be enrolled over the phone. With verbal consent and the waiver of an initiating visit, CMS has greatly streamlined the enrollment process for Chronic Care Management. In fact, these changes mean that CareHarmony is strategically placed to increase your enrollment for Chronic Care Management.
The four types of visits that the Centers for Medicare and Medicaid Services (CMS) have explicitly mentioned as qualifying visits for Chronic Care Management enrollment are:
- Annual Wellness Visit (AWV)
- Initial Preventive Physical Examination (IPPE)
- Comprehensive E&M
- Transitional Care Management
Centers for Medicare and Medicaid Services, “Chronic Care Management Services,” December 2018. [Online: December 2017] https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/ChronicCareManagementServicesChanges2017.pdf