Chronic Care Staffing: What’s Changing in 2025 and How It Impacts Your Practice

Story by CCS Editor / December 17, 2024

Since 2015, Chronic Care Staffing (CCS) has been a trusted partner in delivering clinically driven, patient-centered Chronic Care Management (CCM) solutions. With our innovative approach, we’ve helped practices enhance care coordination, improve patient outcomes, and boost revenue without requiring software integration or upfront costs. As we look ahead to 2025, significant changes to CMS regulations will impact care management services, especially for Federally Qualified Health Centers (FQHCs). Here’s what you need to know about these updates and how CCS can help your practice navigate the transition.


Key Changes to CMS Regulations for 2025

The 2025 CMS Final Rule introduces substantial updates to care management services that aim to optimize reimbursements and expand the scope of care provided to patients. The most notable change is the elimination of the G0511 code for FQHCs, which will be replaced by a range of CPT codes already utilized by private practices.

New Billing Codes and Reimbursement Rates

  • G0511 is being replaced with CPT codes like 99490, 99439, 99484, and 99457.
  • Reimbursement will align with national average rates, which, while lower per service, can be offset by billing additional codes each month.
  • Add-on codes will now be eligible, allowing practices to provide up to 60 minutes of care per patient each month. This additional time can be used for activities like:
    • Health Risk Assessments (HRAs)
    • Preventative screenings (e.g., mammograms, colorectal cancer screenings)
    • Enhanced chronic condition education
    • Extended coordination with specialists and community resources
    • Specialized weight management coaching with dieticians

Advanced Primary Care Management (APCM)

A new program, APCM, has been introduced as an alternative to traditional CCM:

  • APCM 1: For patients with one chronic condition.
  • APCM 2: For patients with two or more chronic conditions.
  • APCM 3: For qualified Medicare beneficiaries with two or more chronic conditions.

This program offers tailored care management without strict time requirements, opening new opportunities for practices to enhance patient care.


Benefits of These Changes

The updated codes and additional care options present a significant opportunity for practices to optimize their care management strategies and revenue streams:

  • Increased Reimbursement Potential: With the ability to bill add-on codes, practices can increase their revenue by providing additional patient care services.
  • Enhanced Patient Care: More time for coordination, education, and preventative screenings means improved patient outcomes and satisfaction.
  • Streamlined Implementation: FQHCs have until July 1, 2025, to fully adopt these changes, providing ample time to adjust workflows and billing practices.

How Chronic Care Staffing Supports Your Transition

Navigating regulatory changes can be challenging, but Chronic Care Staffing is here to make the process seamless. Here’s how we’ll support your practice:

Expert Analysis of Patient Panels

Our clinical team will analyze your patient panels to identify which patients would benefit most from APCM versus traditional CCM. This ensures your practice maximizes both patient outcomes and reimbursement opportunities.

Customizable Workflow Adjustments

We understand that every practice operates differently. Our customizable approach ensures that these regulatory changes integrate smoothly into your existing workflows. From chart reviews to care coordination, we adapt to your needs.

Zero Upfront Costs, Continued Excellence

Our commitment to patient-centered care remains unchanged. With no upfront costs and a focus on clinically driven interactions, you can count on us to deliver meaningful care while your practice focuses on in-office patient services.

Real-Time EMR Integration

Our care coordinators chart every interaction directly into your EMR system in real-time, ensuring accurate documentation and seamless communication with your team.


Preparing for the Future

With the CMS 2025 changes on the horizon, now is the time to adapt and thrive. At Chronic Care Staffing, we’re dedicated to helping practices like yours stay ahead of the curve. From analyzing patient panels to implementing workflow changes, our team is ready to partner with you for a smooth transition and continued success in chronic care management.

If you have questions or are ready to develop a strategy, our clinical team is here to help. Let’s work together to enhance care for your patients and unlock new opportunities for your practice in 2025 and beyond.


Contact Chronic Care Staffing today to schedule a consultation and learn more about how we can support your practice through these changes.

 
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