2021 CPT Codes by the CMS for Medicare Extension Care Management Programs

The chronic care management program was virtually untouched by the 2021 Final Rule from CMS. There are three main CPT codes and two add-on CPT codes in 2021 that may be billed by primary care providers for CCM services.

C

Requirements for CCM:

Non-Complex CCM:

  • Two or more chronic conditions expected to last at least 12 months (or until the death of the patient)
  • Patient consent (verbal or signed)
  • Personalized care plan in a certified EHR and a copy provided to the patient
  • 24/7 patient access to a member of the care team for urgent needs
  • Enhanced non-face-to-face communication between patient