Chronic care management or CCM aims to help patients improve their quality of life. With continuous monitoring, patients can reduce their symptoms, sleep well, and become more physically fit. Care providers use codes to differentiate among patients’ needs. They tag cases with codes 99490, 99487, 99489, and 99491.
Providers assign the first type, Code 99490, to non-complex cases. Under it, clinical staff provide a 20-minute timed service coordinating providers and supporting patient self-care. Meanwhile, 99487 establishes or revises a comprehensive care plan involving complex medical decision-making, and it lasts for 60 minutes.
Centers assign Code 99489 to each successive 30-minute period. You cannot bill this together with Code 99490. Finally, physicians or other qualified health care professionals are the ones who provide 99491 services, which also run for 30 minutes.
What is new in CCM for 2020
According to the Centers for Medicare & Medicaid Services or CMS, “Chronic care management continues to be underutilized.” Beginning January 1, 2020, additional CMS support has allowed for more paid time for patients who need it the most.
Previously, patient engagement drastically went down when the allowable billable time of 20 minutes for non-complex cases has elapsed. Since 99489 cannot cover additional minutes spent for non-complex cases, CMS has created an add-on code specifically for 99490. The new code will be called G2058.
What these changes mean for Code 99490
G2058 allows clinical staff an additional 20 minutes of service time per month, and it pays $37.89. Healthcare providers may bill this code up to two times per month, per patient. This development brings the total possible reimbursement for non-complex services to $118.01.
The new code lets your care team engage patients for up to an hour of non-complex time. This does not only apply to cases needing moderate or advanced medical decision-making, and the patient receives a higher quality of care because of the additional follow-up sessions.
The time spent, though, should reflect the patient’s actual clinical needs. G2058 is a way to enable facilities to utilize their chronic care management teams’ full potential and deploy them to patients who need their services the most.
With this revision, care providers improve patient support and outcomes. Since the threshold of time has increased, they can build a more patient-centered experience and support patients in real-time. Every month, a care provider can engage and build trust with the patient as they move forward in the care plan.
Finally, care plan guidance is now less prescriptive. All care plans will include several elements, including the list of problems, prognosis, measurable treatment goals, and cognitive or functional assessment. They would also have details on symptom management, interventions, environmental evaluation, and caregiver assessment. Finally, care plans would detail interactions, coordination, and review requirements. Note that the comprehensive care plan will not be limited to these elements, and providers can amend it as necessary.
CCM continues to evolve today, especially as medical facilities grapple with the pandemic’s effects on chronic care. Improvements in care practices aim to lower costs and decrease hospitalizations while protecting healthcare providers’ schedules and capacities.
Simplify healthcare and reach out to Medistics Health today. We provide chronic care management through our Remote Patient Monitoring System, helping people schedule appointments, adhere to their care plan, and acquire the support they need. Get in touch with us today for more information.