Martie Ross, PYA Consulting Principal, participates in a discussion about the complexities involved with chronic care management claims for practice patients in a published Part B News article—“Watch Out on Double-Booking CCM as CMS Guides Hospitals in Proposed OPPS rule”—authored by Roy Edroso.
Article Excerpt:
New guidance from CMS may encourage some hospitals to claim chronic care management (CCM) on practice patients, including yours; make sure your patient isn’t over-served.
The 2016 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule, published July 8, included proposed guidance on hospital billing for CCM code 99490, which CMS said it was supplying because it had “received questions about specific requirements for hospitals to bill this code” beyond the requirements in the 2015 Medicare physician fee schedule.
The OPPS rule proposes “that a hospital would be able to bill CPT code 99490 for CCM services only when furnished to a patient who has been either admitted to the hospital as an inpatient or has been a registered outpatient of the hospital within the last 12 months and for whom the hospital furnished therapeutic services.”
Subscribers may read FULL ARTICLE HERE.
For additional guidance related to CCM, check out PYA’s “Providing and Billing for Chronic Care Management” white paper here.
If you’d like more information about CCM services or would like to request a speaker for your event or organization, contact the experts listed below at PYA, (800) 270-9629.
