For background, on January 1, 2015, CMS began reimbursing chronic care management services for qualified Medicare beneficiaries at approximately $40 per member per month under CPT Code 99490. CMS recognized chronic care management as one of the critical components of primary care that contributes to better health outcomes for individuals and reduced healthcare expenditure growth. With the evolution of the program, in 2017, CMS has expanded its CPT family of CCM services to include not only CPT Code 99490 (Chronic Care Management Service), but now the addition of CPT Code 99487 (Complex Chronic Care Management) and CPT Code 99489 (add on code to Complex Chronic Care Management), along with many others. The same CCM services elements are required for all three codes in the CCM family, however, the three codes will differ in the amount of clinical staff service time provided, the complexity of the medical decision making, and the nature of care planning with reimbursement rates ranging from approximately $40 to $92.
eQHealth’s CCM Program is designed to be a turnkey solution for provider practices and organizations seeking to take advantage of the CPT family of CCM services - CPT code 99490 and new CPT Codes 99487 and 99480- without the administrative burden and/or the technology investments required if they were to do all the work themselves. Our robust community-based care coordination services (eQCare®) and technology (eQSuite®) offers a complete solution for executing and billing for CCM services.