Chronic Care Management (CCM) Services

230.2.1– Chronic Care Management (CCM) Services (Rev. 12832; Issued: 09-12-24; Effective:01-01-24; Implementation:10-14-24) A separately billable initiating visit with an RHC or FQHC primary care practitioner (physician, NP, PA, or CNM) is required before care management services can be furnished. This visit can be an E/M, AWV, or IPPE visit, and must occur no more than one-year prior to commencing care management services. Care management services do not need to have been discussed during the initiating visit. Beneficiary consent to receive care management services can be obtained by auxiliary staff under general supervision of the RHC or FQHC primary care practitioner as well as by the billing practitioner, may be written or verbal and must be documented in the patient’s medical record before CCM services are furnished. The medical record should document that the beneficiary has been informed about the availability of care management services, has given permission to consult with relevant specialists as needed, and has been informed of all of the following: • There may be cost-sharing (e.g. deductible and coinsurance in RHCs, and coinsurance in FQHCs) for both in-person and non-face-to-face services that are provided; • Only one practitioner/facility can furnish and be paid for these services during a calendar month; and • They can stop care management services at any time, effective at the end of the calendar month.