Medicare utilizing the last Medicare- Include documentation fields listed above in "all encounter date Add-on payer" section, plus the following: code to Quantity Limits: Verbal consent is documented in the medical record, and 99487, for 99487 may only information must be explained to the patient for each 30- be billed once per transparency minute calendar month, Comprehensive Care Plan for all health issues Problem increment per patient list that does 99489 may be Expected outcome and prognosis beyond 60 quantity billed Measurable treatment goals minutes Symptom management Medicare Planned interventions and identification of the The billing rules for individuals responsible for each intervention CCM (CPT 99490) and Measurable treatment goals complex CCM are the Medication management same, except complex Community/social services ordered CCM requires 60 A description of how services of agencies and minutes of non-face- specialists outside the practice will be to-face care directed/coordinated management services Schedule for periodic review and, when applicable, revision per month, as of the care plan compared to 20 minutes for CCM. to applies” For details and complete listing of CCM CMS also will pay for “Incident service elements: 1) https:// an add-on code for complex CCM, CPT MLN/MLNProducts/Downloads/ChronicCareManage 99489, for each ment.pdf 2) increment that goes beyond the initial 60 minutes.
Medicare Add-on code to 99487, for each increment that does beyond 60 minutes utilizing the last encounter date Quantity Limits: 99487 may only be billed once per calendar month, per patient 99489 may be quantity billed Medicare The billing rules for CCM (CPT 99490) and complex CCM are the same, except complex CCM requires 60 minutes of non-face- to-face care management services per month, as compared to 20 minutes for CCM. CMS also will pay for an add-on code for complex CCM, CPT 99489, for each 30- minute increment that goes beyond the initial 60 minutes. Medicare- Include documentation fields listed above in "all payer" section, plus the following: Verbal consent is documented in the medical record, and information must be explained to the patient for transparency Comprehensive Care Plan for all health issues Problem list Expected outcome and prognosis Measurable treatment goals Symptom management Planned interventions and identification of the individuals responsible for each intervention Measurable treatment goals Medication management Community/social services ordered A description of how services of agencies and specialists outside the practice will be directed/coordinated Schedule for periodic review and, when applicable, revision of the care plan “Incident to applies” For details and complete listing of CCM service elements: 1) https:// MLN/MLNProducts/Downloads/ChronicCareManage ment.pdf 2)
multipayer-g-and-cpt-billing-summary-and-documentation-july-25-2018.docx