CMS – Care Management Services: Remote Monitoring and CCM

Remote Monitoring and CCM

According to CMS, Practitioners who engage in Remote Monitoring of patient physiological data of eligible beneciaries may count the time they spend reviewing the reported data towards the monthly minimum time for billing the CCM code, it counts as part of 20 minute performance of CPT code 99490.

CMS - Care Management Services

Have you heard about new Care Management Services under general supervision for Medicare patients, reimbursed by CMS and available from 2017?

CMS has recently “recognized primary care and care coordination as critical components in achieving better care…” and wants to “encourage long-term investment in primary care and caremanagement services” through “accurate payment”.

From 2017, CMS is Reimbursing the Following:

  • Simplification of the chronic care management (CCM) billing rules.
  • Payment for complex CCM. Complex chronic care management is a service reimbursed on a monthly basis, for a patient who has chronic medical problems which require moderate or high medical decision making- 60 minutes of time spent with the patient.
  • Services: Medical and/or psychosocial need, establish or substantially revise a care plan, problems requiring moderate or high complexity Medical Decision Making (MDM), multiple Illnesses, i.e. Dementia, COPD, substance Abuse, Diabetes (that complicate their care), multiple medication use, inability to perform ADL, require a caregiver, and/or repeat ED visits.
  • Payment for care plan development.
  • Changing Direct supervision to General for CCM furnished by rural health clinics (RHCs) and federally qualied health centers (FQHCs). Thus, the clinical staff member does not have to be physically present in the same suite of offices when providing this service as it was currently performed.
cms - care management services

How CCM is Simplied

Consent form is not required anymore: A physician may simply Document in the beneciary’s medical record that all the elements of consent were provided, and whether the beneciary accepted or declined CCM services. 

How Esvyda may help you

We are ble to keep patient’s information available in your EHR system anytime, anywhere, thanks to our powerful interoperable capabilities.

Initial visit: Such initiating visit is required only for new patients and patients not seen within the last twelve months. 

If an initial visit is required, our solution allows to book that appointment in a very convenient way for you, keeping all the information about the encounter secure and providing insights about the course of this patient’s treatment whether the encounter has been performed online or face-to-face.

24/7 access to care. The requirement regarding access to the beneciary’s care plan is eliminated. 

Although this requirement is eliminated, as a patient engagement strategy, we enable the access of patient’s care plan in a user-friendly way, in a timely manner and available at anytime, not also to patients but also to any authorized person.

Management of care transitions. The continuity of care document does not have to be formatted in a specic manner. Facilitate and coordinate referrrals and follow up after ER or facility discharge. Coordinate with home and community based clinical Service Providers.

We enable care coordination of services, through the enhancement of communication capabilities such as SMS, Chat, Video/Audio Interaction for the management of care transitions. Care team members may share comments and ask for advice with other providers or facilities without disclosing PHI of patients.

Sharing Clinical summaries and care plan information: The electronic care plan must be timely available within and outside the billing practice as appropriate and must be shared electronically (Can include fax) within and outside the practice with people or entities involved in the beneciary’s care. 

Our interoperable capabilities allow Health Care Providers share care plans and clinical summaries with patients and their authorized people as well as with others health care providers involved in their  reatments.

Care plan given to patient: The specification of the format in which the care plan is to be provided is eliminated. May include fax. 

Telehealth Benefits

Our interoperable capabilities allow health Care providers to share plans and clinical summaries with patients and their authorized people as well as with other health care providers involved in the treatment of patients. 

Documentation in the EHR: Such communications must be documented in the patient’s medical record, but not necessarily a qualifying certied electronic health record.

We support the integration of any kind of documentation related to CCM programs in your EHR, available Anytime, Anywhere!

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Esvyda works closely with public and private health plans in all of their available programs, making our solution the most complete out there in the market.

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