Centers for Medicare & Medicaid (CMS) is now paying for chronic care management (CCM) services, recognizing the value that primary care brings to healthcare. CCM is defined as the non-face-to-face services provided to Medicare beneficiaries who have multiple (two or more), significant chronic conditions expected to last at least 12 months, i.e. diabetes, cardiovascular disease, atrial fibrillation (A-fib).

In addition to office visits and other face-to-face encounters, these services include communication with the patient and other involved health professionals for care coordination, medication management and being accessible at all times to patients and any care providers. The creation and revision of electronic care plans is also a key component of CCM.

This Chronic Care Management fact sheet has all the necessary information to begin a CCM program.

This Chronic Care Management tool kit has more in-depth information on billing for CCM services.

Learn more about how atom Alliance is working with providers to improve the coordination of care. atom Alliance is also working to reduce disparities in diabetes and cardiovascular healthcare services.