Significant CCM program Changes for 2017 - released by CMS
Significant CCM program Changes for 2017 - released by CMS Blog Feature
Daniel Godla

By: Daniel Godla on November 17th, 2016

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Significant CCM program Changes for 2017 - released by CMS

2017 updates | Medicare | Chronic Care Management

On November 15, 2016, Medicare published their official changes to the Chronic Care Management (CCM) program beginning on January 1, 2017.  There are significant new changes which will enhance the program and make it easier for practices to enroll their patients. As you know, ThoroughCare's CCM Software allows practices of any size to implement an efficient CCM program. So here's our summary of the new changes:

New CCM Time Categories for MORE THAN 20 MINUTES

  • If you've performed CCM in the past, you know that Medicare paid one reimbursement (Avg of $40) when 20 minutes or more was spent with the patient in a given calendar month. But even if you spent more time than 20 minutes, the reimbursement was the same.
  • In 2017, Medicare will recognize that some patients have Complex Chronic Conditions and require additional time. These new code have been added:
    • 99487: This code pays at 60 minutes of CCM time for Complex CCM Services. It pays around $90.00
    • 99489: This code is for additional increments of 30 minutes beyond the 60 minutes in code 99487. So if you spend 90 minutes, you'd bill for this code as well. It pays an additional $45.00.

Written consent is no longer required by the patient for enrollment

  • For the past 2 years, all CCM patients were required to sign a consent form. This was mandatory in order for CCM services to begin.
  • Effective in January 2017, "written consent" will no longer be required. As long as the patient "verbally agrees" to participate and agrees to the requirements of the program, the patient can become officially enrolled in CCM.
  • If you use ThoroughCare for CCM, the enrollment assessment that you already perform will now be able to eliminate the paper consent form altogether.

An Office visit is not required to begin the CCM Services

  • For the past 2 years, an office visit (E&M) or an Annual Wellness Visit was required to initiate the CCM program.
  • As long as the patient has been seen within the past 12 months, an office visit is no longer required in order to begin CCM with your patients.
  • In 2017, practices can now promote their CCM programs over the phone or through a mailing campaign. Use ThoroughCare's flyers and brochures to promote (and now enroll) your patients without the need of a new office visit.

Care plans can be shared with other providers via Fax

  • Today, Medicare requires that the care plans you create are shared with other providers "electronically". Even though most Certified-EHRs have the ability to do this today, this requirement has created much confusion when specialists or other providers have no means to receive care plans electronically.
  • Beginning in 2017, you will be able to share the patient's information with other providers by Fax.


Overall, we're excited about the new changes. Medicare is clearly taking steps to make CCM more attractive to providers by eliminating many of the barriers to entry.

At ThoroughCare, we're adapting our software so that all of the new changes above will be ready for January 2017. We're most excited about the new levels of CCM time beyond 20 minutes. Some of our practices spend more than an hour with their patients already so they will soon be able to receive higher reimbursements for that work. If you've been debating beginning a CCM program in your practice, there's never been a better time to get started. Contact ThoroughCare so you can start enrolling patients today and will be ready to hit the ground running in 2017. 


About Daniel Godla

Dan is the Founder and CEO of ThoroughCare

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