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The multiple patient focused care codes created by CMS and followed by many commercial payers requires a care plan strategy and billing strategy to optimize care and revenue. For example PCM, has been expanded by CMS to support providers working with patients with just one high-risk condition allowing up to 60 minutes of billable time per month, by both clinical staff and providers.
The differences are easily seen in the billable codes.
| Clinical Staff | |
| 2021 | 2022 |
| G2065 | 99426 |
| $42 | $61 |
| Provider | |
| G2064 | 99424 |
| $74 | $81 |
Obviously if a patient has at least two chronic conditions, then Chronic Care Management (CCM) is a better choice for billable services.
Our practice coaches work with practice front desk staff to ensure reliable customer engagement from payment responsibility determination to wellness focused care coordination.
