Medicare Chronic Care Management
(CPT Codes 99490, 99487, and 99489)

Starting in 2017, CMS is lifting many of the administrative burdens that presented program barriers to entry in 2015 and 2016, with the goal of increasing patient participation. CMS is also improving payment accuracy by appropriately recognizing and paying for other codes in the CPT family of CCM services.

For background, on January 1, 2015, CMS began reimbursing chronic care management services for qualified Medicare beneficiaries at approximately $40 per member per month under CPT Code 99490. CMS recognized chronic care management as one of the critical components of primary care that contributes to better health outcomes for individuals and reduced healthcare expenditure growth.

Several months after CMS established CCM, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 was signed as bipartisan legislation. Additionally, Congress directed CMS to enact a new physician payment system called Merit-based Incentive Payment System (MIPS). At the core of each of these programs and laws (CCM, MACRA and MIPS) are the goals of value-base care. Each program focuses on quality patient care and incentivizes efficiency rather than rewarding volume. The programs are complementary, clinicians and practices that participate in a Medicare CCM program are more prepared for MACRA and MIPS.

With the evolution of the program, in 2017, CMS has expanded its CPT family of CCM services to include not only CPT Code 99490 (Chronic Care Management Service), but now the addition of CPT Code 99487 (Complex Chronic Care Management) and CPT Code 99489 (add on code to Complex Chronic Care Management), along with many others. The same CCM services elements are required for all three codes in the CCM family, however, the three codes will differ in the amount of clinical staff service time provided, the complexity of the medical decision making, and the nature of care planning with reimbursement rates ranging from approximately $40 to $92. 
 

eQHealth’s CCM Program is designed to be a turnkey solution for provider practices and organizations seeking to take advantage of the CPT family of CCM services - CPT code 99490 and new CPT Codes 99487 and 99480- without the administrative burden and/or the technology investments required if they were to do all the work themselves. Our robust community-based care coordination services (eQCare^®) and technology (eQSuite^®) offers a complete solution for executing and billing for CCM services.

eQSuite® CCM Technology

eQSuite^® Chronic Care Management technology is a cloud-based, modular technology platform. It is tailored to not only help meet requirements for CPT code 99490, 99487, and 99480, it goes beyond the requirements to provide features such as analytics, auditing, activity tracking and reporting capabilities. The software’s intuitive design helps providers, care teams and administrators leverage a sophisticated workflow engine designed to effectively manage patients with two plus chronic conditions and allows easy collaboration among all continuums of care providers.

eQSuite® CCM technology is the ideal platform to create and manage your member’s information, interventions and care plan outcomes. To learn more about the features and benefits of eQSuite® CCM technology, download our Chronic Care Management eQGuide.

eQCare® CCM Services

eQCare® Chronic Care Management Services administer and manage your chronic care management program and take on the burden of hiring, staffing, and operating it with an experienced team to give the best care to your patients. Our experience in providing the right community-based care coordination coupled with advanced software will reduce the burden of managing the program in-house and give providers the confidence that their patients are getting the care they need. 

eQCare® Chronic Care Management Services support providers by administering CCM activities for Medicare patients with two or more chronic conditions. Our goal is to help improve the health of patients and member quality outcomes while providers grow practice revenue and profitability. To learn more about the features and offerings of eQCare® CCM Services, download our Chronic Care Management eQGuide.

Why Choose eQHealth for Chronic Care Management?