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Alhambra Palace

Presented by:

Chicago, IL


Chronic Care Management (CCM)

Over 55 Million Americans Receive Medicare Benefits*

55+ Million Americans are Medicare Recipiants

2/3 of Medicare Patients have 2 or more Chronic Conditions

Two Thirds of Medicare Recipiants have 2 or more Chronic Conditions

Providers trying to navigate through managing their own chronic care and transitional care management patientsThe Centers for Medicare and Medicaid Services (CMS) began reimbursing providers who actively manage care delivery for Medicare patients suffering from two or more chronic conditions in January 2015, under the Medicare Physician Fee Schedule for Chronic Care Management Services under CPT code 99490. All services may be contracted with a third party (NavCare).

Chronic care management pays for itself in reduced ER visits, reduced complications and reduced re-hospitalizations. Providers who plan to launch a chronic care management (CCM) program have the option to either hire additional nurses and administrators who can train on how to use CCM software OR let NavCare do it.

**If physician determines that the patient is eligible for CCM services, physician must discuss CCM services with the patient during their Annual Wellness, Initial Preventive Physical Exam, or Comprehensive Evaluation and Management visit.

*Source: CMS Beneficiaries as of May 2015,
†Source: cdc.gov/pcd/issues/2013/12_0137.htm

CCM Testimonial

DrJones 184x230I know they have benefited from CCM several times in meaningful ways. They know their nurse by name and it’s the same nurse that calls on them each time. That makes a big difference. The care has far exceeded my expectations with real tangible stuff like giving them appropriate medical advice, getting timely appointments, answering questions, and checking to make sure they are following through with the care (and getting better).

Suffice it to say I’m very impressed.

-  Derek A. Jones, MD, F.A.C.S.
Pensacola, FL

CMS Links

CMS pays for CCM under the Medicare Physician Fee Schedule (PFS). Access the Medicare PFS Look-Up tool to find payment for Chronic Care Manager for a specific location:

PFS Look-Up Tool

Helpful Links to CMS Chronic Care Management FAQs

Physician Fee Schedule
Hospital Outpatient PPS

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NavCare | 933 Broad St., Suite 301 | Augusta, GA 30901
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