A Practical Checklist for being able to bill for Care Coordination Management services
(99490 - $42 per month per chronic health conditions patient for providing none face-to-face care coordination management services)
1) Medicare beneficiary with 2 or more chronic conditions expected to last 1 year
2) At least 20 minutes of none face-to-face care coordination services per month
3) Educate patient about the service including the ability to cancel consent at any time
4) Obtain written beneficiary consent (see sample consent template below)
? We scan the signed consent into the imported items section of the patient?s chart
5) Only one provider can provide CCM to a beneficiary at one time
6) Provider must use a certified EMR for medical records keeping
7) Collaborate on developing a care plan with the beneficiary at least annually during a Care Plan visit (cc: Care Plan visit).
? We use MyPHTS web based patient centered service for care management to collaborate with patients to develop patient centered care plans using tablets to access the web based interactive assessments (tablets are inexpensive, the brand we use is less than $250)
? We then enhance my Amazing Charts by incorporating the patient centered care plan from MyPHTS into my Amazing Charts Care Plan visit note in the ?Plan? section.
? The completed Care Plan is the visit?s clinical summary plus the incorporated patient centric care plan plus the Continuity of Care Document (CCD).
? MyPHTS costs $49.99 PER PROVIDER per month (if you had three providers in your office that?s $150 per month)
? Other CCM web based services being advertised cost $25 to $30 PER PATIENT per month (if you had 100 eligible patients in your office that would be about $3000 per month)
? MyPHTS is for a lot more than Care Plans. It is an easy to use patient centric tool to engage patients with their providers in care management. It includes web-based assessments some done by patients independently and some like the Care Plan done in collaboration with the care team. Modules include are Annual Health & Wellness, Care Plans, Chronic Health Conditions, Urgent Conditions, Practical Weight Management, streamlined Personal Health Record, Nutrition and Fitness, and Personalized Health Education. It was designed by practicing primary care physicians seeking a patient centric tool for a patient centered approach to medical care. It is flexible and easy for you and your patients to use in the way that best fits your practice.
Request a Demo of MyPHTS by contacting Practical Health Technology Solutions MyPHTS team at info@myphts.net. Each subscription starts with a one month free trial.
MyPHTS:
www.myphts.com 8) ) The care plan must be in electronic format and be made accessible to all members of the care team that are providing CCM services and whose time is being counted towards the time requirement (simply means the team has access to your EMR)
9) Care plan info must be able to be shared electronically as appropriate with specialists or other providers caring for the patient. You can achieve this through your Amazing Charts just include the plan section of the care plan visit in the CCD document you export when appropriate.
10) The patient must have access to the care plan.
? Provide your patient with a copy of the clinical summary and associated care plan developed during the visit in paper or electronic format through your patient portal.
11) Document the CCM service as it occurs including time spent
? Create templates to facilitate your documentation in Messages section or Addendum section of your Amazing Charts
? (ex: Care Coordination Management
? Reviewed ?.
? Plan ?.
? Time spent: ..minutes
? Your name}
12) Bill 99490 ($40.39) on a monthly basis when you have provided and documented at least 20 mins of CCM services for a patient
13) Maintain a monthly log of your eligible patients. And use your existing resources to identify and keep track of those that really need the services to improve their health and wellbeing.
14) We are keeping the CCM consents and the billing associated with the services in a separate folder from our regular weekly billing folders so we can be able to search for quick reference
If you find this information useful let me know. You can contact me below with further questions or to schedule a demo of MyPHTS: info@myphts.net
Many of us are already providing the care. It's nice that the care of our patients is finally being recognized. Hope the above helps others chart a pathway to reimbursement. Get the word out to your colleagues who may not be yet aware of how to actually get it done. This service just became billable January 1, 2015. Would love it if you'd take some minutes to check out MyPHTS too. Practically useful technology doesn't have to cost your practice its arm and its leg.
Sincerely,
MKO
Sample Consent template: (use at your own risk and use your own diligence to review for compliance with the expectations of the consent; January ACP Internist article "Chronic Care Management at Last and How to Code for It" by Brian Outland is a good reference)
Care Coordination Management Consent:
1) CCM is for coordinating the care of patients with more than one chronic health conditions that has lasted at least 12 months or is expected to last through out the lifetime. It involves at least 20 minutes of none face to face follow ups during a month. These follows ups can involve activities such as the following: discussions with you by phone, or through the use of web-based services, or secure-messaging, or other methods that are not face-to-face for the purpose of coordinating care with your other providers such as home health services or specialists, or medication management such as with your pharmacy, or other care coordination efforts related to you that are not face to face or do not involve your visiting the office.
2) Only one physician can provide CCM services to you at a time.
3) Your health information will be shared with other providers of healthcare services to you including by electronic communication as permitted by healthcare privacy regulations.
4) You may cancel your consent to this service at any time by canceling your consent. Your cancellation will be effective at the end of the calendar month in which you cancel.
5) CCM services is offered as part of your Medicare benefits and the same rules about your responsibility for any copayments or deductibles apply.
The above has been reviewed with me and I consent to Care Coordination Management service by Dr. [insert name]
Printed Name _________________________________ Date of Birth__________________
Signature_____________________________________ Today?s Date: ________________
I am canceling my consent to Care Coordination Management Services.
Printed Name _________________________________ Date of Birth_____________________
Signature_____________________________________ Cancellation Date: ________________
