ELEVATE YOUR WORKFLOW
Grow your CCM services with Comprehensive Data Reporting
We provide the majority of the 20 min required to bill CPT 99490
We deliver comprehensive clinical reports, treatment recommendations, and time required (up to 40 min) to bill CPT 99439
By accessing patient data on the EHR we are able to provide data on diagnosis, vital signs, ADL’s, nutrition, behaviors, medications, bowel patterns, FLACKER score and more
Tailored Reports that meet CMS criteria for CCM
Increasing Revenue while Improving Outcomes
Our methods allow us to maximize the full potential of CCM
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In addition to CPT 99490:
Between 70-82% of patients achieve 20 minutes of clinical staff time, qualifying for CPT 99439
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22-40% of patients require a more in-depth review, resulting in qualifying for CPT 99439 a second time
Tailored Report
Our clinical and design team will work with you to tailor your report
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Utilize your company branding ​Relevant clinical findings
Supporting documentation Tailored report formatting
Review Period
60 day look-back for Vital Sign trends
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30 day look-back for Functional Status, Medications, and other relevant clinical indicators
Advanced Clinical Review
Clinical review performed by highly-trained clinical team
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Checks for clinical viability according to CMS requirements
Comprehensive Reports
Recent and relevant clinical data used to provide treatment suggestions and insights
CPT RECOMMENDATIONS
Listing of CPT codes viable based on the time we spend working with your patients
Chronic Care Management (CCM)
At least 20 minutes of clinical staff time directed by a physician or non-physician provider are spent managing the patients’ health and chronic conditions.
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A comprehensive care plan must be established, implemented, or monitored.
CPT 99490
(2024, reimburses ~$61)
CPT 99439
(2024, reimburses ~$47 per instance)
Billable after the first 20 minutes of CCM furnished by clinical staff under supervision of the provider.
Billable for each additional 20 minutes after 99490, up to a maximum of two times.
Principle Care Management (PCM)
Principal Care Management (PCM) services is the same information as Chronic Care Management with exception that it only focuses on a single chronic condition.
Condition may last 6 months to 1 year
The condition puts the patient at high risk for condition to worsen and be admitted to the hospital.
Remote Patient Monitoring (RPM)
CPT Code 99453
(2024 average pay rate: ~$19)
Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment. this code is generally billed once per patient on the initiation of RPM services.
CPT Code 99454
(2024 average pay rate: ~$46)
Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission minimum; each 30 days is the monthly code that reimburses for the supply of the device and monitoring of patient data. This code requires that patient readings be performed at least 16 days each month.
CPT Code 99457
(2024 average pay rate: ~$48)
Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; initial 20 minutes.
CPT Code 99458
(2024 average pay rate: ~$38)
Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes.
For the first 20 minutes of logged management time each month a practice can bill 99457. Once 99457 has been billed, a practice can add up to two instances of 99458 at 40 minutes and 60 minutes, respectively.
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Both 99457 and 99458 can be furnished by clinical staff under the general supervision of the billing provider.
Behavioral Health Integration (BHI)
- A patient can have only one chronic condition, and it must be a mental health condition.
- A validated assessment must be performed on the patient each month to track progress.
- This can be completed over the phone, and there are many quick validated assessments in the public domain.
- Time spent on the validated assessment counts towards the 20-minute requirement.
CPT 99484
(2024, reimburses ~$54)
It is capped at 20 minutes, but you can bill BHI and CCM in the same month if you exceed 20 minutes. BHI is billed each calendar month.
First 20 minutes of BHI furnished by clinical staff under supervision of the provider.
Remote MDS Coordinator
​Accuracy & Timeliness
Dedicated focus assures assessments are accurate and on time.
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Enhanced Reimbursement
Facilities benefit financially when MDS assessments are handled with precision, as accurate data supports proper reimbursement rates and avoids losses due to overlooked documentation errors.
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Preparedness for Contingencies
Offers a reliable backup plan for future staffing needs.
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Cost Savings
Remote MDS coordination can be more affordable than traditional staffing models, reducing costs associated with travel, relocation, and potential interim staffing solutions.