Chronic Care Management (CCM) national reimbursement is $42.17 ($67 for FQHCs). CCM requires twenty minutes of non face to face monthly activity on behalf of enrolled patients. Who’s eligible? Any Medicare and Medicare Advantage patient with two or more chronic conditions.
Behavioral Health Integration (BHI) national reimbursement is $48.65. Monthly service guidelines are similar to CCM, including 20 minutes of non face to face activity on the patient’s behalf. Who’s eligible? Any Medicare and Medicare Advantage patient that has a mental, behavioral health, or psychiatric condition being treated by the billing practitioner, including substance use disorders, that, in the clinical judgment of the billing practitioner, warrants BHI services. The diagnosis or diagnoses could be either pre-existing or made by the billing practitioner and may be refined over time.
Annual Wellness Visit (AWV) average reimbursement is $350 (with additional codes). This typically includes additional codes for patient assessments. AWV is service that includes a Health Risk Assessment (HRA) and brief patient exam that helps providers keep current with their patients healthcare. A Health Risk Assessment is one of the most widely used screening tools in the field of health promotion. All Medicare and Medicare Advantage patients are eligible for this annual service.