Throughout my many years of servicing physicians as their biller, one common complaint I have heard is about time spent on unbillable services. “My staff and I spend an awful amount of time helping patients over the phone; is there any way I can get paid for that?” Physicians also want to know if they can be paid for services provided in between patient visits, such as completing forms, medication refills, and telephone consults. My response has always been “no”; there was no reliable way to get doctors paid for these types of services. Now however, some of that has changed with Medicare’s new willingness to pay for Chronic Care Management Code 99490.
CPT code 99490 is defined as: Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements:
Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient;
Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline;
Comprehensive care plan established, implemented, revised, or monitored.
As of January 1st, 2015, Medicare allows a payment of $47.45 for Chronic Care Management. In this blog post, we’ll explore some rules and tips on how to document, and bill for this service.
