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2015 Medicare Fee Schedule Offers Payment for Chronic Care

Code pays for clinical staff time for developing, implementing care plan for chronic conditions

WEDNESDAY, Dec. 24, 2014 (HealthDay News) -- The 2015 Medicare Fee Schedule includes a Current Procedural Terminology Code that pays for clinical staff time for developing and implementing a care plan for patients with two or more chronic conditions, according to an article published Dec. 18 in Medical Economics.

Noting that the payment comes in response to primary care physicians who spend time trying to coordinate care to manage patients with chronic conditions, the article reports that payment is $46.20 for 20 minutes of staff time and can be billed once per patient per calendar month.

According to the article, approval of the code continues the trend of Medicare paying for non-face-to-face care and acknowledges and begins to address the large and growing share of the nation's health care spending that is devoted to those with chronic health conditions. Use of the code is limited with scope-of-service and billing requirements. In addition, the time spent on activities covered under the code will need to be tracked. Other challenges include deciding who qualifies for coverage under the code, and obtaining patient consent to provide chronic care services and pay the requisite $8 copay.

"The code was developed especially to address staff time spent on those activities, as well as the physician's time coordinating that work and supervising the staff," Cindy Hughes, a former coding and compliance consultant for the American Academy of Family Physicians, said in the Medical Economics article.

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