Chronic Care Management Tool Kit: What Practices Need to Do to Implement and Bill CCM Codes

Chronic Care Management (CCM) is defined as the non-face-to-face services provided to Medicare beneficiaries who have multiple (two or more), significant chronic conditions. In addition to office visits and other face-to face encounters (billed separately), these services include communication with the patient and other treating health professionals for care coordination (both electronically and by phone), medication management, and being accessible 24 hours a day to patients and any care providers (physicians or other clinical staff).

These codes are generally intended for use by the clinician who is providing the majority of the care coordination services, which most often would be the primary care internist. However, certain specialists may be able to provide the services needed to qualify to bill the CCM codes, but never in the same month as the primary care physician.