CHRONIC CARE MANAGEMENT (CCM) CPT 99490 REIMBURSEMENT

Chronic care management (CCM) covers the administration and education activities conducted by health care professionals to help patients with chronic diseaseand health conditions such as diabetes, high blood pressure, multiple sclerosis, lupus, heart conditions, sleep apnea, et al. This is to help patients understand their disease and health conditions, manage and live successfully with them. The health care providers motivate patients to persevere in necessary therapies and interventions and helpthem to achieve an ongoing, reasonable quality of life.

The treatments for chronic diseases are often complex making it difficult for patients to comply with treatment protocols. In order to gain effective medical care in treating chronic conditions, longer visits to the doctor’s office may be necessary. Medical or behavioral interventions may differ in effectiveness too depending on at what stage of the illness the intervention is suggested.

Certain obstacles related to chronic disease conditions are not particularly medical but involve patients’ interactions with families and workplaces. Sometimes, extreme and difficult lifestyle changes are required for interventions. Education of patients on the benefits of treatment and the risks of not properly following thetreatment regimen is necessary. Patients need motivation to stay compliant and help them understand that treatment produces an improved state in health if not the desired effect of cure. Chronic care management helps patients systematically monitor their progress and coordinate with health care experts to identify and solve any problems they encounter in their treatment. Crucial medical interventions and close, careful coordinationfrom multiple specialists may not always work together posing a risk for patients with chronic diseases.

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