COMPLEX CCM 99487
Extended Code for Complex Medical Decision Making
More than one-third of the patients currently enrolled in Chronic Care
Management would benefit from or need a more thorough following.
CMS is reimbursing since 2017 for additional care under code 99487 and
99489 for Complex CCM.
- Fuller care plans
- Coordination with providers outside your practice
- Additional time spent on and with your patients
- Social services close to your CCM patients
Understanding the Requirements of Code 99487
This code is specific to Chronic Care Management and is the reimbursement of chronic care services for patients with:
Two or more chronic conditions
At least one condition being unstable
At least two risk factors from at least two separate domains
To be reimbursed for such care, practices must:
Contact each eligible patient every month.
Conduct at least 60 minutes of non face-to-face care.
Establish, implement, revise or monitor a comprehensive complex care plan.
Each additional 30 minutes of complex care is billed
under the add-on CPT code 99489.
Non-Face-To-Face Care Services
To help provide the best care to your patients, our nurses offer personalized care to each patient, alternating between telephonic and purposeful emailing & SMS every month.
E-Mail & SMS Modules
- First Care Plan Creation
- Medication Analysis
- Additional Care Plan Creation
- Preventive Health Analysis
- Initial Care Plan Review
- Medication Review
- Subsequent Care Plan Review
- Symptoms Management
- Preventive Health Review
According to CMS, these chronic conditions include*:
- Acquired Hypothyroidism
- Acute Myocardial Infarction
- Alzheimer’s Disease & Related Disorders
- Asthma Atrial Fibrillation
- Benign Prostatic Hyperplasia
- Cancer, Colorectal
- Cancer, Endometrial
- Cancer, Breast
- Cancer, Lung
- Cancer, Prostate
- Chronic Kidney Disease
- Chronic Obstructive Pulmonary Disease
- Heart Failure
- Hip/Pelvic Fracture
- Ischemic Heart Disease
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Learn how Connect Care Plus helps patients better manage chronic conditions