Proven CCM Billing Solutions for Optimal Results
< 30
Days in AR
10-15%
Revenue Increase
97%
First Pass Ratio
96%
Collection Ratios
98%
Clean Claims Rate
CCM in Medical Billing
The Centers for Medicare & Medicaid Services (CMS) recognized chronic care management (CCM) as a critical component for improving health outcomes for patients having two or more chronic conditions. The program creates an opportunity for healthcare providers to attain higher profitability through an added revenue stream.
Chronic care management billing enables physicians to bill for time-based services. However, it also increases work for providers as they must identify eligible patients and enroll them in the CCM program while implementing, monitoring, or revising care plans for chronic patients. Besides, the reporting of CCM services requires specific documentation and CPT codes.
Challenges in Chronic Care Management Billing
Medical billing and coding for chronic care management, too, is complicated. Healthcare providers participate in this value-based care program by CMS to improve patient health outcomes and streamline their revenue cycle. However, the following challenges in CCM medical billing often disrupt payment collections and make it difficult to find financial stability.
Patient Eligibility
Determining who qualifies for chronic care management services is the biggest challenge in CCM billing. Only those with at least 2 chronic illnesses, lasting over 12 months are eligible.
Documentation Requirements
Next comes the extensive documentation requirements. Healthcare providers must maintain complete documentation, including assessments, chronic conditions, and care management plans for CCM billing against rendered chronic care management services.
Incorrect Coding
Using inaccurate codes to bill time-sensitive CCM services or not following the criteria for bundled procedures during chronic care management billing can lead to missed revenue and reduced cash flow.
Staffing Shortages
The chronic care management program allows healthcare providers to add a new revenue stream to their practice. However, shortages of CCM medical billing staff can drag their practice down.
Why Choose MediBill MD for CCM Billing Services?
Are you tired of not being able to find financial stability with all these intricate CCM billing requirements? Great news! Your worries are about to end!
We at MediBill MD house a team of chronic care management billing specialists and certified professional coders (CPCs) ready to offload you of this complicated process. Partner with us to realize a healthier revenue cycle.
When you outsource chronic care management billing services to MediBill MD, you get access to CCM billing and coding specialists who are well-versed in the intricacies of its eligibility, documentation, coding, and claim submission.
CCM billing has unique rules and regulations that the billing team must follow to ensure timely and higher reimbursements. Our team strives to stay compliant, improving your overall collection rate.
Staff shortage is a nightmare for providers leveraging the CCM program. When you outsource CCM billing services to MediBill MD, you can scale up or down based on your monthly CCM patient enrollments.
Enrolling eligible patients in the CCM program can boost your practice's profitability. However, hiring additional billing & coding staff and investing in infrastructure is challenging. But not when you choose MediBill MD for chronic care management billing services.
You can free up your staff to oversee patient-facing care during chronic care management treatments by outsourcing the administrative and CCM medical billing and coding activities to us. More staff equals to quality healthcare.
Management Practices Nationwide
The varying federal and state laws related to medical billing and coding guidelines often keep healthcare practices on the edge. Not anymore! At MediBill MD, we have billing and coding champions trained in different state laws and payer guidelines.
So, whether you are practicing in Alaska or Arkansas, get our chronic care management billing services across all 50 states of the USA.
Common CPT Codes for CCM in Medical Billing
Chronic care management billing has unique coding requirements and billing guidelines that healthcare providers must follow to ensure rightful reimbursements from Medicare payers for their rendered CCM services. Here's a look into the most common CCM CPT codes and their descriptions.
| Common CPT Codes for CCM Billing | MediBill MD Solution | |
|---|---|---|
| 99490 | Used for billing 20 minutes of non-complex CCM services every month. | |
| 99439 | Used for billing an additional 20 minutes of non-complex CCM services twice a month. | |
| 99487 | Used for billing 60 minutes of complex CCM services virtually each month. | |
| 99489 | Used for billing an additional 30 minutes of complex CCM services monthly and there is no limit on how many times you report it. | |
| 99491 | Used for billing the first 30 minutes of non-complex CCM services in which the healthcare provider or non-physician practitioner is heavily involved. | |
| 99437 | Used for an additional 30 minutes of CCM services in which the healthcare provider or non-physician practitioner is personally involved. | |
Setting up an in-house CCM medical billing and coding team is easier said than done! Dump the complexities and outsource chronic care management billing services to our expert team at affordable rates.
Price Comparison Calculator
Based on your annual collections, we will calculate the in-house medical billing cost and compare it with the MediBill MD service charges.
Get In Touch With Our
CCM
Billing Specialist
Interested in the CCM program but don’t have the resources to meet chronic care management billing requirements? Connect with our CCM billing specialists today and let them manage your revenue cycle.
FAQs
When you outsource chronic care management billing services to MediBill MD, you don’t have to worry about hiring, training, and retaining CCM billing specialists and coders, saving you from overhead and operational costs.
MediBill MD charges 2-5% of your monthly collections for the provision of its chronic care management billing services.
Verifying patient eligibility, maintaining detailed documentation of assessments, coding chronic conditions and treatment plans, and generating accurate medical claims are the most challenging aspects of chronic care management billing.
Your documentation for chronic care management billing must emphasize that the patient has/had two or more chronic diseases lasting at least twelve months or until the patient died. You must have the patient’s consent (verbal or signed), a personalized care plan in a certified electronic health record (EHR) system, and its copy which will be provided to the patient.
No, the same physician cannot bill for CCM services and hospice care during the same month. The only way they can be billed together is when two different providers from different group practices are involved in the care, one billing for hospice care and the other for CCM services.
HCPCS code - G0506 is the new G-code providers can use to bill comprehensive face-to-face assessments and chronic care management planning.
