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CCM Overview — Chronic Care Management is a U.S. Centers for Medicare & Medicaid Services (CMS) program for individuals with multiple chronic diseases. CCM focuses on behavior change coaching for Medicare patients with two or more chronic conditions. Approximately 80% of older adults have at least one chronic disease, and 77% have at least two or more.¹ Offering CCM enables healthcare providers to sustain and grow their practice and most importantly, improve patient health.

 

RPM Overview — Remote Patient Monitoring enables the monitoring of patients outside of conventional clinical settings through the assistance of technology. This increases a patient’s access to health care, while decreasing delivery costs. RPM allows patients to use connected medical devices to perform routine tests and send the data to health care professionals. 

 

Better Together — Chronic care management and remote patient monitoring work together to improve patient health care. RPM allows caregivers to pay close attention to CCM patients health data to provide proactive care rather than reactive care. CCM and RPM work together to extend quality care and build closer relationships with patients. Incorporating RPM in chronic care management can significantly improve an individual’s quality of life. CCM and RPM can be billed in the same month because CMS recognizes the two services are complementary. 

 

CPT® code  99453:

“Remote monitoring of physiologic parameter(s) (e.g, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on

use of equipment.” The Medicare payment for these services is $21.

CPT® code 99454:

“Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.” The Medicare payment for these services is $69.

CPT® code 99457:

“Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.” The Medicare payment for these services is $54.

 

¹ Facts About Healthy Aging | NCOA. (2015, June 03). Retrieved from https://www.ncoa.org/news/resources-for-reporters/get-the-facts/healthy-aging-facts

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