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Big Changes to Medicare Care Management in 2025 - Texas Hospital Association
The 2025 Medicare Physician Fee Schedule Proposed Rule introduces several major changes to CMS’s policies and reimbursements. Texas health systems now face a new conversion factor and the removal of code G0511 for Chronic Care Management (CCM) programs. But providers will also have the opportunity to engage with a new care management service, called Advanced Primary Care Management (APCM), which could revolutionize how you offer preventative care to patients.
Medigy Insights
The proposed 2025 Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule rule would eliminate billing code G0511 for chronic care management (CCM) for rural health clinics and FQHCs, meaning those providers must instead use individual codes like CPT 99490—potentially reducing reimbursements by about 14%.
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