Care Management Blog

The Centers for Medicare & Medicaid Services (CMS) released the Final Rule for its 2025 Medicare Physician Fee Schedule. It includes a significant change for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).

An opinion piece in the American Academy of Family Physicians’ (AAFP) FPM journal identified care management as an “essential strategy” for success in primary care practices. Despite growing evidence demonstrating its potential to improve the health of the most at-risk patients, Chronic Care Management (CCM) adoption by rural providers has been slower than their urban counterparts.

UPDATE (1/8/2025): In its 2025 Final Rule, CMS changed the rules pertaining to HCPCS code G0511. Read here for the latest information.

Rural healthcare has existed outside the influence of many value-based programs. With low case rates and specialized reimbursements, rural care clinics have not been folded into the transition.

More than 46 million—or 15% of Americans—live in medically-underserved rural communities. About 70% of rural, or partially rural, counties are considered Health Professional Shortage Areas. And nearly one in 10 counties have no physicians at all.

The Centers for Medicare & Medicaid Services (CMS) announced key reimbursement rates, additional CPT codes, two program expansions, and an entirely new care management program, effective January 1, 2023.

Care Coordination and Wellness programs, with goals of improved health, better care and lower costs, continue to expand. Unfortunately, these programs lag behind in many rural communities. But programs like Chronic Care Management (CCM) are tailor-made for the rural population. Here are 6 reasons Rural Health Providers need CCM: