Your Top 5 Questions about Chronic Care Management Billing Answered

By Elizabeth Woodcock  |  January 7, 2015

Watch NowAs a follow up to the recent webinar, Getting Paid in 2015: What You Need to Know, speaker Elizabeth Woodcock and Kareo have answered the questions posed by participants. Many of the questions were about billing for the new chronic care management reimbursement. Here are answers to the five most common questions.

Q: Can you bill the 99490 if you have a patient face-to-face visit in that month?
A: Yes, you can bill the Chronic Care Management (CCM) code, 99490, in the same month as you might see the patient (and bill a regular E/M code), just so you fulfill the requirements for the code.  

Q: So you can see the patient several times a month if needed and charge E/M codes and the 99490 code as well once a month.
A: Yes, you can bill the 99490 once a month in addition to the other face-to-face visits. 

Q: Is the 99490 just for Medicare or also Medicaid and other payers?
A: Currently, this is a Medicare reimbursement but as with other instances like this other payers may follow. You’ll need to check with your state Medicaid office or other payers to see if they are also going to pay for this service. 

Q: Can 99490 be used by mental health providers?
A: The code can be used by any physician; it is not restricted to certain specialties. However, it is intended to be the physician who has established the patient’s care plan, and is managing it. This includes the needs for the patient, across the spectrum of care.

Q: When two physicians charge monthly chronic management code for a Medicare patient, who gets paid?
A: Since only one physician can bill for the patient, the first one to bill is the one who gets paid.

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