Hello Christopher,
We noticed a similar trend too even despite Meaningful Use. It makes a person wonder. For this year, we are focusing on the new Care Coordination Management and Transitional Care Management services codes that became effective January 1, 2015. We are using a web-based patient-provider engagement service called MyPHTS along with our EMR Amazing Charts for documenting our care coordination and transitional care management efforts. Many of us already provide these services; it's just a matter of using an affordable and effective service along with our EMR to enhance our current efforts and enable charge capture for the services being provided. MyPHTS is designed by actively practicing primary care physicians and is affordable costing $49.99 per provider per month:
www.myphts.comI posted a detailed checklist on how we use MyPHTS to facilitate care coordination management services and our Amazing Charts to document our services. The checklist also includes how to bill for Care Coordination Management services. My post is under General Discussions and is titled: How to Bill for Chronic Care Management Services (99490 - $42/patient/month)
Healthcare is going through a great change management. The future is going to be about chronic health conditions management and transitional care management when patients are being discharged from hospitalizations. If you are already noticing a downward trend, then you really won't have a choice but to learn how to effectively participate in the great change.
Christopher, below is a summary of new service codes effective January 1, 2015 that you and your solo doctor need to learn about. Hopefully in the process you will also contact me through info@myphts.net to learn more about how MyPHTS can help you along in your process. My practice uses MyPHTS and I also conduct demos for MyPHTS.
Summary of Care Coordination and Transitional Care Management Codes:
Care Coordination Management (CCM) services - 99490 ($42/patient/month)
for 20 minutes of non face-to-face care coordination time per patient per month (instead of
being reactionary, we are being encouraged to become more proactive with care management of
patients with 2 or more chronic health conditions); can be personal, telephonic, web-service,
secure messaging
(Using MyPHTS to facilitate the requirements of the above costs our practice $49.99/provider/month)
Transitional Care Management (TCM) services - 99495 ($164/patient/30-day period post discharge)
-discharged patient with moderate complexity medical decision making during the service period
-communicate with patient or caregiver within 2 business days of discharge
-have a face-to-face visit within 14 calendar days of discharge
-service period is 30-day period that begins on date of discharge
-DOS reported should be the 30th day
Transitional Care Management (TCM) services - 99496 ($231/patient/30-day period post discharge)
-discharged patient with high complexity medical decision making during the service period
-communicate with patient or caregiver within 2 business days of discharge
-have a face-to-face visit within 7 calendar days of discharge
-service period is 30-day period that begins on date of discharge
-DOS reported should be the 30th day
Regards,
MKO
