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Who Can Bill?

As of January 1, 2015, Medicare began reimbursing for Chronic Care Management (CCM) services using CPT Code 99490. This service is for Medicare patients with multiple chronic conditions and is non-face-to-face. The new reimbursements are in line with CMS’ move to focus on higher quality primary care in an effort to reduce spending and improve outcomes.

Physicians as well as non-physicians may bill for CCM services:

  • Physician Assistants
  • Nurse Practitioners
  • Certified Nurse Midwives
  • Managing care transitions
  • Clinical Nurse Specialists

Clinical staff, working under the general supervision of an eligible practitioner, may also provide the CCM service. It’s important to note that if two practitioners within a practice both provide CCM for the same patient, only one may bill for the code in any given month.

The CCM codes (CPT 99487, 99489, and 99490) are assigned general supervision under the Medicare. General supervision means when the service is not personally performed by the billing practitioner, it is performed under his or her overall direction and control although his or her physical presence is not required.