The inclusion of payment for chronic care management code 99490 in the 2015 Medicare Physician Fee Schedule has good implications for payment of this code by other health plans. However, the instructions for reporting chronic care management are often seen as complex as caring for patients with multiple chronic conditions. The following questions and answers may be helpful.
Current Procedural Terminology (CPT®) does not limit coverage to specific chronic conditions but defines the patient population for care management services as those patients with 2 or more chronic continuous or episodic health conditions that both
Practices should note that one capability required for provision of chronic care management services is use of a standardized methodology to identify patients who require care management services.
Physicians may wish to develop a checklist for identifying patient characteristics that place a patient at significant risk, such as (Note: examples only; not intended...