Nov 20, 2015

Reimbursements for Chronic Care Management Services

Alanna Diffendal   |   Updated June 28   |  Reading time: 2 minutes

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The Chronic Care Management (CCM) service program calls for reimbursements to eligible healthcare providers who treat patients with two or more chronic conditions. The Center for Medicare & Medicaid Services (CMS) recognizes the need to improve the treatment outcomes for disease prevention.

On January 1, 2015, CMS began paying healthcare providers for CPT Code 99490 for Chronic Care Management. The average reimbursement for CCM in 2015 is $42.60 per visit, per month and is based on the provider’s fee schedule location. Eligible patients that meet the qualifications for CCM services require at least 20 minutes under general supervision by a physician or another qualified healthcare professional. Other qualified healthcare professionals and specialists include Physician Assistants, Nurse Practitioners, Clinical Nurse Specialists or Certified Nurse Midwives. Read the CMS Requirements here. This fact sheet provides helpful background on the newly payable chronic care management (CCM) service. It also identifies eligible providers and patients, and details the Medicare PFS billing requirements.

Eligible providers do not need to participate in Meaningful Use, but must meet the CCM criteria utilizing Certified EHR Technology (CEHRT) in order to receive reimbursements for this program. RXNT’s electronic health record solution, RXNT|EHR, provides templates that assist healthcare professionals in documenting CCM services and enables end user providers to seamlessly submit payable billing codes into its practice management solution, RXNT|PM.

All the key points, background, and frequently asked questions helpful to a provider in determining how to successfully navigate and participate in the Chronic Care Management (CCM) service reimbursements on CMS’ website (Read the full CMS MLN Matters article here).

About RXNT

Networking Technology, Inc. dba RXNT, based in Annapolis, MD, develops innovative software solutions for ambulatory care practices. RXNT has been a leader in cloud-based software for over 16 years with a fully integrated line of solutions including RXNT|PM (practice management), RXNT|EHR (electronic health records), and RXNT|eRx (electronic prescribing). For more information about RXNT|EHR, or RXNT’s other software solutions, visit us online at, call us at 800-943-7968 Ext. 3, or follow us on LinkedIn.

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