There are the new CPT codes and they apply only to Medicare patients with two or more significant chronic conditions.  Anymore that’s becoming more common as we have more chronic conditions to diagnose:)  As a quick example that can add up imageto some additional money, again it depends on the demographics of the practice patients.  There’s also mention of bundling two of the CPT codes and there’s no details yet on how that will work.  Speaking of bundling let’s not forget this one CMS is trying to model with bundled episode payments too. 

The Four Models of Bundled Care - 3 Year CMS Algorithmic Patient Care Improvement Initiative, Yet One More Model To Enrich Health IT Profits With Complexities, Variables Will Kill This Model In Time…

I understand models and how they need to work but I also understand the complexities of them as well and the difficulties of sometimes administrating in the real world too.  In addition there’s some flexibility on the $40 dollar a month billing to include services performed by staff as part of the entire management process.  In addition, finally some telemedicine provisions, which everyone has been waiting for along with wellness visits.  This will be interesting to see how this new $40 billable allowance goes for chronic conditions and hopefully it won’t lead to additional quantitated and complex reporting for doctors with attachments, etc. like meaningful use is has turned out to be, more complex hassle than what the last leg of the program is worth.  BD 

Starting Jan. 1, about $40 per patient per month can be earned for non-face-to-face chronic care management services, such as developing and revising the care plan, communicating with other treating providers, and managing medications.

The billing codes – CPT codes 99490 and 99487 and 99489 – apply only to Medicare patients with two or more significant, chronic conditions. CMS plans to make a bundled payment for codes 99487 and 99489, according to the rule.

CMS will also allow more “flexibility” in the supervision of clinical staff who provide care coordination services. Under the rule, physicians can bill “incident to” services provided by clinical staff members, even if they are not direct employees and are under general, but not direct, supervision.

The fee schedule final rule also expands access to telehealth services for Medicare beneficiaries. Medicare will now allow annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management services to be performed via telemedicine.


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