WE MAKE CCM EASY

utilizing personal Smartphone, tablet, computer OR land line

CCM is the care coordination that is outside of the regular office visit for patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient. Medicare has decided to tackle the challenges of chronic diseases by provisioning care its fee-for-service (FFS) model, where CPT codes would be used to reimburse chronic care by physicians. The reimbursable program is comprised of two components:

REMOTE PHYSIOLOGIC MONITORING (RPM)

E/M codes billed by a Provider for collection of data transmitted to healthcare providers.

  • At least 16 data points per 30 days (ie: BP, O2, HR, Wt., etc.)

  • Automated data capture electronically (ie: Bluetooth, WiFi)

  • At least 1 monthly video or phone call

  • Can be delivered incident to general supervision of billing provider

CHRONIC CARE MANAGEMENT (CCM)

E/M codes billed by a Provider for Care Coordination delivered outside of the regular office visit.

  • At least 2 or more Chronic Conditions

  • 24/7 Access to Care

  • Ongoing Care Plan Customization & Revision per Practitioner Oversight

  • Medication Management

Benefits to CHL’s Shared Revenue Solution

  • Turnkey RPM and staff solution exceeds reimbursement guidelines

  • Pre-built CCM Workflow and Reporting

  • Live 24/7 Response and Access to Care

  • Ongoing Care Plan Customization and Revision per Practitioner Oversight

  • Optional billing and coding

CODE DESCRIPTION REIMBURSEMENT CHL SOLUTION OTHER RPMs
99453 RPM Set-Up & Patient Education ~$18.80 Included Not Included
99454 RPM Med Device Recordings for at least 16 out of 30 days ~$61.90 Included Not Included
99457 Non-face-to-face Interactive Communication: 20 min/month ~$50.94 Included Not Included
99458 Additional 20 minutes of care ~$41.17 Included Not Included
99490 First 20 min of non-complex CCM & 24/7 access to care ~$41.17 Included Not Included
99439 Additional 20 min of non-complex CCM ~$37.94 Included Not Included
99487 First 60 min for complex care & 24/7 access to care ~$91.77 Included Not Included
99489 Additional 30 min for complex care ~$43.97 Included Not Included