You will need to identify your chronic care patients who qualify.
Eligible patients include those with two or more chronic conditions expected to last at least 12 months, or until death, that place the individual at significant risk of death, acute exacerbation/decompensation, or functional decline.
Only one provider can bill for the chronic care management code in a 30-day period.
You must have a signed agreement with the patient allowing you to bill for these services and detailing cancellation rights, copayments and types of services.
Among other things, you need to provide 20 minutes or more of chronic care management services per patient per 30 day billing period.
You will need to create a patient-centered care plan document compatible with the patient’s choices and values.
You must provide either a written or electronic copy of the care plan to the patient.
You will need to manage care transitions between and among health care providers and settings.
Bill in accordance with CMS requirements using a G-code, making sure your software provides the information you need to manage and bill for this program.