June 16, 2016 – PHV is now assisting members on Accountable Care Metrics with Chronic Care Management, our offering is called MyMedTrac.
The Medicare Chronic Care Management Program is an additional revenue stream for each health systems that participates.  Approximately two-thirds of Medicare patients are eligible for the program, and average reimbursement to the provider is $42 per patient, per month.
It is a CPT billing code 99490, and is non-face to face time with a clinical professional which can be a RN, LPN, CMA, or CNA.  The nurse calls the patient once per month for 20 minutes and reviews the patients’ health status, chronic conditions, and goals.  CMS has proven outcomes on reduced hospital admission/readmissions, ER visits, and improved HCC scores for patients participating in these programs.

  • The Chronic Care Management Program is also one key to CMS quality reporting success in the coming years-MIPS(Merit Based Incentive Payment Program):Key to CMS Quality Reporting Success in the coming years-MIPS
  • The Center for Medicare & Medicaid Services (CMS) will begin measuring performance for doctors and other clinicians through MIPS in January 2017, with payments based on those measures beginning in 2019.-Participating in a Care Coordination Program such as CCM 99490, will account for 15{a825b113fa7e7f7df3124aad37f306612c93d04c1401cc72a54a1f67d114723a} of the total score in the first year.For more information contact Beth Petersen at 402-650-8258 (beth.petersen@phvne.com)

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