2025 Chronic Care Management Compliance: Improve Patient Engagement and Maximizing Reimbursement
Course Description:
CMS had made with multiple changes throughout the past 14 years (adding more codes, adding new concept – principal care management, advanced primary care management). CCM has become a hugely profitable endeavor for many healthcare providers. More vendors are coming to the “playground” with their software, clinical teams, and billing capabilities. Providers must be more vigilant in choosing CCM vendors because the billing is always done under providers making them accountable for everything the vendor is doing. Understanding compliance, knowing best practices, and starting off appropriately is essential for a Chronic Care Management program to be effective, compliant, and efficient.
This webinar will outline the 2025 guideline changes as well as revisions made by the CMS. This session will highlight what is needed to keep providers compliant with billing Chronic Care Management services. Nationally recognized RPM and CCM Expert Dr. Irina Koyfman, DNP, NP C, RN discuss the new principal management code and how that plays into the care of patients. These codes will be discussed as CMS recognizes chronic care as a critical component of care that contributes to better health and care for those we serve. Dr. Irina Koyfman will review the latest CMS Medicare’s changes in care management and also guide you to how to be proactively compliance with these changes. These changes in physician payment policies can impact your practice’s reimbursement and payment systems.
Learning Objectives:
- To Verbalize Key Component of CCM
- To Summarize Evaluation Plan
- To Know the 2025 CMS Newly Added Concept - APCM
- To Identify Chronic Care Management Best Practices
- To Identify What is Needed for the Implementation Plan
- Review CMS’s Chronic Care Management (CCM) and Principal Care Management (PCM) Requirements
- Examine Scope of Services Required to Bill Medicare for CCM/ PCM Services
- Identify How CCM can Close Care Gaps and Engage Patients
- Identify CCM/ PCM Compliance Issues
- Implement Best Practices
- Assess the Financial and Quality Implications of Incorporating CCM in your Practice
Areas Covered in the Session:
- History of CCM
- 2025 – Introduction of the Advanced Primary Care Model (APCM) – New
- What is Chronic Care Management
- CCM Activities
- Patients’ Eligibility
- Examples of Chronic Conditions
- Provider Responsibility
- Initiating Visit
- Consent – Written or Verbal
- Consent Template
- Comprehensive Care Plan
- CCM Billing
- Who can bill for CCM?
- Who can provide CCM
- Clinical Staff as per CPT and CMS Definition
- CCM Compliance
- Know The CCM Rules
- Principle Care Management (PCM)
- CCM Platforms Overview
- Compliance Question
- Can CCM be provided by physicians/ NPPs or staff located outside of the United States?
- Can you bill 99490 (20 minutes) without a conversation with the patient?
- Can you have third party doing your CCM?
- Can CCM services be completely delegated to clinical staff?
- Do you have to assign each patient to a care team
- What to look for in the Clinical Team
- Best Practices
- Advanced Primary Care Management (APCM)
- APCM 13 Service Elements
- Billing for APCM
- Level 1: HCPCS G0556
- Level 2: HCPCS G0557
- Lever 3: HCPCS G0558
Suggested Attendees:
- Physicians
- Nurses
- Doctors
- Nurse Practitioner
- Population Health Officers
- Innovation officers
- CFO/ CNO/ CMO
- Chief Clinical Officer
- Billers and Coders
- PCP (MD, NP, PA)
- Specialists (MD, NP, PA)
- Nurse Managers
- C-Suite Healthcare Executives
About the Presenter:
Dr. Koyfman is a Nurse Practitioner and Doctor of Nursing Practice with over 30 years of nursing experience and 20 years in executive leadership. An entrepreneur at heart, Dr. Koyfman has founded four successful healthcare ventures, achieving remarkable operational growth (up to 1,000%), building high-retention teams, and consistently improving patient satisfaction and outcomes. As a Subject Matter Expert in CCM and RPM, she is a sought-after presenter at national conferences. In her role as founder of Affinity Expert, she consults primary care practices on the clinical, operational, and financial implementation of CCM and RPM.
Dr. Koyfman also fosters a vibrant community of clinicians through her CCM/RPM groups on Facebook and LinkedIn, offering free educational resources to providers. Committed to service, she volunteers on multiple boards and participates in hands-on volunteer work, reflecting her dedication to giving back to the healthcare community she serves.
Additional Information:
System Requirement:
- Internet Speed: Preferably above 1 MBPS
- Headset: Any decent headset and microphone which can be used to hear clearly
For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com
Snippet From Our Previous Session:
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Testimonials:
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"Great presentation. Able to do during the day. Timing was great"
Tina Duffy, Compliance Officer