What is Chronic Care Management?

What is Chronic Care Management?

The importance of chronic care management is acknowledged by the Centers for Medicare and Medicaid Services. More than two-thirds of recipients have two chronic conditions, according to CMS, and almost 14 percent have more than six chronic conditions.

Chronic care services are important for patients with two or more chronic health conditions. Because of their disabilities, chronic care programs assist recipients with a greater risk of deterioration or death.

We will cover all the information you need to know about handling your chronic conditions in the content below. We're going to go through eligibility, services, and doctors who can bill.

Does Medicare pay for Chronic Care Management?

In treating your chronic conditions, Medicare will pay for the help of your doctor. Your Medicare Part B benefits will come under chronic care service. You will have to pay for your deduction, coinsurance, and copays from Medicare Part B. You may pay even less if you have a Medigap plan.

Because these services are covered by Medicare, an Advantage plan would also cover you when you need this form of coverage.

The aim of this program is to provide you with organized, high-quality treatment that will help you achieve better health.

Who can bill for Chronic Care Management

Chronic Treatment can be billed by the following medical professionals:

  • Physician Assistants

  • Nurse Practitioners

  • Midwives

  • Nurses Specialist

Doctors who can not bill for these services include:

  • Dental professionals

  • Psychiatrists

  • Psychologists

  • Podologists

  • Limited-License Physicians 

What is Chronic Care Management?

Who are Qualified for Chronic Care Management

You must be eligible for Medicare to get the Chronic Care Management covered by the federal program. Otherwise, you would need to check your health plan for your alternatives,

If you suffer from two or more chronic illnesses, you are eligible for Medicare's Chronic Care Management Programs. It must be expected that these conditions will last at least 12 months or until the patient dies.

Also, you can take benefits of the advantages Medicare has to offer if you're eligible. The more treatment you have when you have health conditions, the less likely complications can occur.

Many of the chronic conditions that are most prevalent include:

  • Diabetes

  • Cardiac Disease

  • Arthritis

  • Asthma

Services for chronic management can include:

  • Frequent check-ins with your doctor

  • Emergency access to health care providers 

  • Develop a treatment plan with your doctor

  • At least 20 minutes of health services management care every month


Tip: Treatment of chronic care is not the same as the coordination of care you get after an inpatient hospital stay.


How to Enroll in Medicare in Chronic Care Management

You need to consult with your doctor to enroll in chronic care management. This usually involves an in-person appointment, however, you should talk about your options with your doctor.

You will need to give your consent during your doctor's appointment to start accessing managed care. Finally, an in-depth care plan for your future will be established by you and your doctor.

Frequently Asked Questions

Can Medicare Advantage Patients enroll in chronic care management?

Medicare Part B benefits are this type of treatment. If you're an Advantage beneficiary, if you apply, you may qualify in chronic care management.

How much or often will you be billed for chronic care?

Once a month, doctors can charge for chronic treatment. But for these services every month, only one practitioner can be charged.

Why is the management of chronic care critical?

For those with serious health problems, chronic care management is important. It may help patients control these conditions on an ongoing basis, potentially decreasing discomfort and increasing comfort, mobility, and even lifespan.

If you have a chronic illness, read more about your options.

Conditions of chronic health can cause stress and cost money. Thankfully, with these added expenditures, Medigap plans can help.

Although many of your medical expenses are covered by Medicare, it doesn't cover every expense you'll face. You can get support with copays, deductibles, and co-insurance when you participate in a Medigap plan.


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