CMS Chronic Care Management: Future-Proofing Chronic Care with 2025 Updates
CMS adding more codes and adding new concepts like Principal Care Management, fees increment etc. for the effective care management. Chronic Care Management (CCM) has become a hugely profitable endeavor for many healthcare providers. More vendors are coming to the “playground” with their software, clinical teams, and billing capabilities. Providers must be more vigilant in choosing CCM vendors because the billing is always done under providers making them accountable for everything the vendor is doing. Understanding compliance, knowing best practices, and starting off appropriately is essential for a Chronic Care Management program to be effective, compliant, and efficient.
This webinar will outline guideline changes as well as revisions made by the CMS. This session will highlight what is needed to keep providers compliant with billing Chronic Care Management services. We will discuss the new principal management code and how that plays into the care of patients. These codes will be discussed as CMS recognizes chronic care as a critical component of care that contributes to better health and care for those we serve. Expert Dr. Irina Koyfman, DNP, NP-C, RN, will review the latest CMS Medicare’s changes in care management, Federally Qualified Health Centers (FQHCs), preventive care, behavioral health services and telehealth; and also guide you to how to be proactively compliance with these changes. These changes in physician payment policies can impact your practice’s reimbursement and payment systems.
Learning Objectives
To verbalize key component of CCM
To summarize evaluation plan
To identify what is needed for the Implementation Plan
Review CMS’s Chronic Care Management (CCM) and Principal Care Management (PCM) requirements
Examine Scope of Services required to bill Medicare for CCM/ PCM services
Identify how CCM can close care gaps and engage patients
Identify CCM/ PCM compliance issues
Implement Best Practices
Assess the financial and quality implications of incorporating CCM in your practice
Recognize the importance of CCM in relation to quadruple aim
Areas Covered in the Session
History of CCM
2025 – Introduction of the Advanced Primary Care Model (APCM) – New
What is Chronic Care Management
CCM Activities
Patients’ Eligibility
Examples of Chronic Conditions
Provider Responsibility
Initiating Visit
Consent – Written or Verbal
Consent Template
Comprehensive Care Plan
CCM Billing
Who can bill for CCM?
Who can provide CCM
Clinical Staff as per CPT and CMS Definition
CCM Compliance
Know The CCM Rules
Principle Care Management (PCM)
CCM Platforms Overview
Compliance Question
Can CCM be provided by physicians/NPPs or staff located outside of the United States?
Can you bill 99490 (20 minutes) without a conversation with the patient?
Can you have third party doing your CCM?
Can CCM services be completely delegated to clinical staff?
Do you have to assign each patient to a care team
What to look for in the Clinical Team
Best Practices
Advanced Primary Care Management (APCM)
APCM 13 Service Elements
Billing for APCM
Level 1: HCPCS G0556
Level 2: HCPCS G0557
Lever 3: HCPCS G0558
Suggested Attendees
Nurses
Doctors
Nurse Practitioner
Population Health Officers
Innovation officers
CNO/ CMO
Billers
Physicians
PCP (MD, NP, PA)
Specialists (MD, NP, PA)
Nurse Managers
C-Suite Healthcare Executives
About the Presenter
Dr. Irina Koyfman, DNP, NP-C, RN, is a Nurse Practitioner and a Doctor of Nursing Practice with 25 years of nursing and 15 years of executive experience. Dr. Koyfman is an expert in the Patient-Centered Medical Home (PCMH), Home Health, Healthcare Start-ups, Transitional Care, Community Health, Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and Care Coordination. Dr. Koyfman is a dedicated and enthusiastic clinician with an entrepreneurial drive. She has a history of establishing 4 successful healthcare ventures, where she drove significant operational growth (up to1,000%), built successful teams with high retention rates, and improved patient satisfaction and patient outcomes. She is a Subject Matter Expert in CCM and RPM, making her a frequent presenter at multiple conferences. As a founder of Affinity Expert, a healthcare consulting company, she has been consulting primary care providers on all aspects of CCM and its successful clinical, operational, and financial implementation. She has created a growing community of clinicians through her CCM/RPM groups on Facebook and LinkedIn where she provides free information and education to providers. She loves to give back and volunteers on multiple boards along with hands on volunteer work.
Additional Information
System Requirement:
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to hear clearly
For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com