Billing for Chronic Care Management: What Are the Problematic Issues?

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Catherine Short speaks with Markus P. Cicka, J.D., LL.M. (Health Law), owner of the Law Office of Markus P. Cicka, LLC, a law firm based in Saint Louis, Missouri, about the topic of “Billing for Chronic Care Management: What Are the Problematic Issues?” Beginning in 2015, CMS allowed Medicare payments to providers under the Medicare Physician Fee Schedule (“PFS”) for chronic care management (“CCM”) in certain situations. Prior to 2015, physicians could not bill separately for typical non-face-to-face care management services in these situations. While the implementation of a CMS policy for CCM payments should be applauded, healthcare providers billing for CCM should be aware of certain issues recently flagged by the OIG. We will discuss what is chronic care management, have an understanding of who exactly can bill for providing chronic care management services, and discover what are recent chronic care management billing issues that have been flagged by the OIG. 

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1 Comment. Leave new

  • DiaMey Dakota SpencerBerry
    October 1, 2020 3:22 pm

    Thanks so much for the explanation of the Remote Patient monitoring and CCM. I understand the situation so much better now.


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