2023 Rules for CPT 99490 & Other Chronic Care Management Codes

2023 Rules for CPT 99490 & Other Chronic Care Management Codes

The rules for coding chronic care management (CCM) have undergone significant changes in recent years, and there's a host of new changes taking effect in 2022. If you've come to read this blog post, you're presumably looking for the rules you should be following to perform proper chronic care management (CCM) billing and coding. That's good. While the federal government has been increasingly supportive of care management programs, they are also more closely scrutinizing CCM reimbursement by auditing instances and causes of overpayment associated with incorrect billing of the service. And there's every reason to believe that the federal government, including the Centers for Medicare & Medicaid Service (CMS) will be paying even closer attention to chronic care management (i.e., CCM) going forward. The agency is putting substantial money behind the care management service, which provides coverage for patients with 2+ chronic conditions for a continuous relationship with their care team. Thus, the importance of ensuring that you appropriately and consistently following the rules of CCM codes and CCM billing has probably never been greater. 

Medigy Insights

The rules for chronic care management (CCM) billing and coding have undergone significant changes in recent years, with additional changes taking effect in 2022. While care management programs have gained support, the federal government is closely scrutinizing CCM reimbursement, with audits focused on instances of overpayment resulting from incorrect billing. The Centers for Medicare & Medicaid Service (CMS) is investing substantial funds in care management services, emphasizing the importance of proper CCM billing and coding. Compliance with CCM codes is critical for practitioners to receive proper reimbursement, and it is vital to maintain accuracy and consistency in following the rules for CCM billing.


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