2023 Rules for CPT 99490 & Other Chronic Care Management Codes

The rules for coding chronic care management (CCM) have undergone significant changes in recent years, and there's a host of new changes taking effect in 2022. If you've come to read this blog post, you're presumably looking for the rules you should be following to perform proper chronic care management (CCM) billing and coding. That's good. While the federal government has been increasingly supportive of care management programs, they are also more closely scrutinizing CCM reimbursement by auditing instances and causes of overpayment associated with incorrect billing of the service. And there's every reason to believe that the federal government, including the Centers for Medicare & Medicaid Service (CMS) will be paying even closer attention to chronic care management (i.e., CCM) going forward. The agency is putting substantial money behind the care management service, which provides coverage for patients with 2+ chronic conditions for a continuous relationship with their care team. Thus, the importance of ensuring that you appropriately and consistently following the rules of CCM codes and CCM billing has probably never been greater.