CMS bumps fees for CMS, elevates TCM

by: Julia Kyles, CPC Nov 6, 2019

CMS scaled back many of the proposed changes to chronic and transitional care management services (CMS), but a few made it to the final rule. Next year you’ll have an add-on code for chronic care management code provided by clinical staff and two codes for management of a single high-risk condition.

CMS also made adjustments to the fees that range from a loss of less than $2 to a gain of more than $20. That’s based on national calculations, your fees will vary based on your locality. The following chart provides a quick overview of what your revenue will look like in 2020. Watch upcoming issues of Part B News and other DecisionHealth publications for more details.

Code	Short descriptor	2019	2020
99490	Chronic care management services at least 20 minutes per calendar month	$42.17	$42.22
+G2058	Chronic care management services, each additional 20 minutes of clinical staff time	N/A	$37.89
99491	Chronic care management services by qualified health care professional, 30 minutes or more per calendar month	$83.97	$84.09
99487	Complex chronic care management services 60 minutes clinical staff time	$92.98	$92.39
+99489	Complex chronic care management services each additional 30 minutes clinical staff time	$46.49	$44.75
99495	Transitional care management services, moderately complexity, requiring face-to-face visits within 14 days of discharge	$166.50	$187.67
99496	Transitional care management services, highly complexity, requiring face-to-face visits within 7 days of discharge	$234.97	$247.94
G2064	Comprehensive care management services for a single high-risk disease, e.g., Principal Care Management, at least 30 minutes of physician or other qualified health care professional time per calendar month	N/A	$92.03
G2065	Comprehensive care management for a single high-risk disease services, e.g. Principal Care Management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	N/A	$39.70

By the way, here is the comparison for behavioral and psychiatric care management services.

99484	Care management services for behavioral health conditions, at least 20 minutes clinical staff time	$48.65	$48.00
99492	Initial psychiatric collaborative care management, first 70 minutes in the first calendar month	$162.18	$156.99
99493	Subsequent psychiatric collaborative care management, first 60 minutes in subsequent month of behavioral health care manager activities	$129.38	$126.31
+99494	Initial or subsequent psychiatric collaborative care management, additional 30 minutes in the first calendar month	$67.03	$63.88

Source: PBN analysis of the Medicare 2020 final physician fee schedule — Addendum B

Blog Tags: CMS, E/M services, fee schedule

To comment, login here.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.