CMS has now leveraged technology to bring better care to patients suffering from chronic diseases. With CCM and RPM, these patients are now spending less time hospitalized for their multiple conditions and spending less from conflicting medication. Best of all, exacerbations and downslides are prevented and the interval of wellness where patients are productive and relatively free of pain is prolonged.

Doctors and other Providers are now given a chance to monitor patients and catch early worsening of symptoms and debilitation. The increase in longevity brings its own set of problems since a number of these patients are prevented from access to quality care due to lack of transportation, caregiver support, and financial constraints. The widespread use of unbundled CPT codes for qualified Medicare patients heralds a better quality of life and increased billable hour for clinicians. With all these advantages, it is a mystery why some practices are still reluctant to offer these services. Even if the potential revenue is understood, the costs of hiring more clinicians or clerical support and the possibility of outsourcing are daunting to fledgling practices. One thing that is worrisome for clinicians is staying up-to-date with regulations and complying with value-based care. Prevounce simplifies and automates the workflow so you can maximize outreach and your existing staff, as you provide essential services that are good for your patients and great for your practice.

Added Streams and Scalability

Maximizing reimbursable returns for delivering quality non-face-to-face coordinated care for qualified patients suffering from two or more chronic diseases can be done by adding other preventative and counseling visits, even if these are face-to-face visits.

CCM Codes

  • CCM Initiating Visit AWV, IPPE, TCM or Other Face-to-Face E/M. $44-$209
  • CPT 99487, Complex CCM, $94
  • CPT 99489, Complex CCM Add-On, $47
  • CPT 99490, Non- Complex CCM, $43
  • CPT 99491, 30 min, $74.26 (can’t be reported in the same month as CPT codes 99490 and 99487
  • G0506, Add-On Code to CCM Initiating Visit, $64
  • G0511 For Rural Health Clinics and FQHCs, $65
  • CPT 99358, Prolonged evaluation and management, the first hour, $113
  • CPT 99359, Prolonged evaluation and management, next 30 minutes. $55

Remote Patient Monitoring (RPM)

The effectiveness of CCM is complemented by proactive RPM. Patients with limited access to clinical care benefit greatly from this remote delivery of services since dangerous spikes or untoward changes are caught early. Because of this, the cost of healthcare delivery is greatly reduced and potential hospitalization avoided. Since RPM is done conveniently outside clinical settings, monitoring can be done with ease practically anywhere and anytime. Because of better engagement, patients are more confident about the state of their health and are likely to express satisfaction and recommend the practice to others.

  • CPT code 99091,$59
  • CPT code 99453, $21
  • CPT code 99454, 20 min., $69
  • CPT code 99457, 20 min. $54

CCM and RPM prevent patients from experiencing adverse drug interactions and getting conflicting information or advice due to a lack of care coordination. Poor physiologic monitoring leads to rapid progression of the disease, debilitation, frequent hospitalization, loss of functionality, and premature death. Integrating Prevounce into your system is the scalable, efficient, affordable, and secure solution that helps you cope with recently implemented regulatory and billing changes.