Pennsylvania Targeted in New CMS Chronic Care Management Initiative

Last Updated: May 21, 2017

117 million American adults—half the adult population—have a chronic condition. And, two-thirds of Medicare beneficiaries have two or more chronic conditions.

In response to the need for chronic care management (CCM) services, the Centers for Medicare and Medicaid Services (CMS) introduced the Connected Care initiative. The nationwide initiative includes a focus on racial and ethnic minorities as well as rural populations, who CMS says tend to have higher rates of chronic disease.

Connected Care also targets four states, including Pennsylvania, with a focus on rural and urban representation. In Pa., the target regions are:

  • Philadelphia (urban)
  • Snyder County (rural county)

With CCM, patients get a comprehensive care plan that offers them the support they need to stay healthy. Physicians and practices can improve care coordination, increase patient compliance with treatment plans, and find opportunities for growth.

New Connected Care Tools and Resources

On March 15, 2017, CMS launched a Connected Care resource hub at http://go.cms.gov/ccm which offers resources such as:

What You Need to Know about CCM Reimbursement

Many clinicians who offer already provide CCM services may not be aware that full separate payments for CCM are available under Medicare Part B.

In 2015, Medicare began issuing a separate payment for CCM services. And, effective Jan. 1, 2017, CMS implemented changes—which include new CPT codes, an add-on G-code, and service element revisions—in order to enable reimbursement for more complex and time-intensive chronic care coordination.

The Pennsylvania Medical Society's (PAMED) "Chronic Care Management Services" Quick Consult explains what physicians need to know about CCM reimbursement.

Get the CCM Quick Consult

PAMED members with questions can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.


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