Wiki Medicare case/care management

[cmubrat101]

Hello! We have case/care managers at our office that use the G9001 and G9002 for Coordinated care fee, initial rate, and coordinated care fee maintenance rate. With Medicare, they do not accept these codes, and do not pay anything on them. I am wondering if there is a different way to bill these so they get to Medicare. Everything that I see says that Medicare will not accept the code, only a 99490 for chronic care management. I understand that we are not suppose to bill them, but I'm trying to find information to give to my manager about not being able to bill for them. So if you have information about either what codes you bill Medicare for these codes, or why you cannot bill medicare for these codes, it would be extremely helpful!

Thank you!
Nicole H CPC

 

[Pam Warren]

The HCPCS Code G9001 is billable only if you are a Coordinated Care Demonstration site. See Transmittal AB-01-30.
Chronic Care Management codes have very specific documentation and patient guidelines. Look at Medlearn Matters article SE1516. There is a lot of information from CMS on the CCM codes, a simple Google search will get you to the most important articles. Just make sure they come from cms.gov.