CCM Billing Codes and Electronic Health Records Quiz

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What type of insurance may cover more for patients alongside Medicare?

Wrap-around insurance

Primary insurance

Medicaid insurance

Supplemental insurance (correct)

Which group of individuals is typically not responsible for cost sharing in terms of healthcare?

Individuals with private insurance

Dual-eligible individuals (correct)

Medicare beneficiaries

Individuals with employer insurance

Who can provide Chronic Care Management (CCM) services?

Only Critical Access Hospitals

Only Physician's Assistant

Only Physicians

Nurse Practitioner, Certified Nurse Midwife, Clinical Staff (correct)

Which of the following is NOT an example of a chronic condition mentioned in the text?

Influenza Signup and view all the answers

What type of health centers are eligible to bill for Chronic Care Management (CCM) services?

Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Critical Access Hospitals Signup and view all the answers

What is one of the main benefits of CCM services?

Improve patient satisfaction Signup and view all the answers

When did CMS adopt CPT code 99490?

January 1, 2015 Signup and view all the answers

Why did Medicare create CCM services?

To bill for ongoing CCM services more easily Signup and view all the answers

What do care plans provide caregivers with?

Guidelines for assisting loved ones with healthcare activities Signup and view all the answers

What did CMS do in 2017 regarding billing codes for CCM?

Introduced new billing codes Signup and view all the answers

Which code did CMS replace with 99439 in 2022?

G2058 Signup and view all the answers

What is one of the main differences between CCM (non-complex) and complex CCM?

The amount of clinical staff service time provided Signup and view all the answers

For complex CCM billing, what is necessary for the billing practitioner to personally perform?

High complexity medical decision-making Signup and view all the answers

Which of the following is NOT required in order to submit a claim for CCM services to Medicare?

Social Security Number (SSN) of the patient Signup and view all the answers

What is an important step in the process of billing for CCM services?

Checking that CMS requirements were met for each patient monthly Signup and view all the answers

Why is it helpful to know the care manager assigned to a case in the event of an audit?

To ensure they are billing correctly Signup and view all the answers

What is one requirement when billing for CCM services via telehealth?

Specifying the place of service as telehealth Signup and view all the answers

What type of information must be recorded in Electronic Health Records (EHRs)?

Patient's demographics, medical problems, medications, and medication allergies Signup and view all the answers

How often should patients be able to contact healthcare providers according to the text?

24 hours a day, 7 days a week Signup and view all the answers

What is the average reimbursement for CPT Code 99439?

$48 Signup and view all the answers

Which code is used for CCM services personally provided by a physician?

CPT Code 99491 Signup and view all the answers

What does CPT Code 99437 represent?

Additional 30 minutes provided by a physician or other qualified healthcare professional per calendar month Signup and view all the answers

How much is the total average reimbursement for providing CCM services personally as per CPT Code 99491 and its add-on code?

$147 Signup and view all the answers

What is the main purpose of CPT Code 99487?

To establish or revise a comprehensive care plan involving moderate- to high-complexity medical decision-making Signup and view all the answers

How much is the average reimbursement for CPT Code 99487?

$134 Signup and view all the answers

In CCM billing, how much non-face-to-face clinical time must be spent on care for a patient to bill for CCM?

20 minutes Signup and view all the answers

Can both complex and non-complex CCM be reported for the same patient in the same calendar month?

No Signup and view all the answers

Which services cannot be billed during the same service period as CCM codes?

Home health care supervision, hospice care supervision, and certain ESRD services Signup and view all the answers

What is the additional reimbursement for each additional 30 minutes of clinical staff time spent providing complex CCM alongside CPT Code 99487?

$71 Signup and view all the answers