The Role of Medical Assistants in Medicare CCM and TCM

Donald A. Balasa, JD, MBA, has served as Chief Executive Officer and Legal Counsel of the American Association of Medical Assistants (AAMA) and leads this informative webinar.

The Medicare Chronic Care Management (CCM) and Transitional Care Management (TCM) programs are relatively new and are growing quickly. Individuals who are part of the Medicare Fee-For-Service program and meet certain criteria are eligible for CCM or TCM services provided by physicians and non-physician practitioners. These providers are permitted to delegate certain CCM and TCM tasks to unlicensed clinical staff such as medical assistants and receive reimbursement for such tasks as incident to the services of the provider.

The purpose of this webinar is to clarify what CCM and TCM tasks are and are not delegable to medical assistants, and what types of provider supervision are required. Citing explicit language from the CPT Code Book and the Medicare Benefit Policy Manual, the presenter will disprove the misconception that all CCM and TCM tasks may only be delegated to licensed professionals (such as RNs and LPNs).

1. The attendee will be able to delineate which Medicare patients are eligible for the CCM program, which are eligible for the TCM program, and which services are covered by each program.
2. The attendee will be able to explain which health care providers are permitted to furnish and bill for CCM and TCM services, respectively, and which CPT codes are used for submitting claims for these services.
3. The attendee will be able to determine which tasks and duties, under state law, must be delegated to licensed health care professionals, and which may be delegated to unlicensed allied health professionals such as medical assistants, and which tasks performed by medical assistants are reimbursable under CCM and TCM as incident to the services of the delegating provider.