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Format: On-Demand Webinar
Presenter: Dr. Irina Koyfman, DNP, NP-C, RN
Time: You can access the webinar anytime
Duration: 60 minutes
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CMS adding more codes and adding new concepts like Principal Care Management, fees increment etc. for the effective care management. Chronic Care Management (CCM) has become a hugely profitable endeavor for many healthcare providers. More vendors are coming to the “playground” with their software, clinical teams, and billing capabilities. Providers must be more vigilant in choosing CCM vendors because the billing is always done under providers making them accountable for everything the vendor is doing. Understanding compliance, knowing best practices, and starting off appropriately is essential for a Chronic Care Management program to be effective, compliant, and efficient.

This webinar will outline guideline changes as well as revisions made by the CMS. This session will highlight what is needed to keep providers compliant with billing Chronic Care Management services. We will discuss the new principal management code and how that plays into the care of patients. These codes will be discussed as CMS recognizes chronic care as a critical component of care that contributes to better health and care for those we serve. Expert Dr. Irina Koyfman, DNP, NP-C, RN, will review the latest CMS Medicare’s changes in care management, Federally Qualified Health Centers (FQHCs), preventive care, behavioral health services and telehealth; and also guide you to how to be proactively compliance with these changes. These changes in physician payment policies can impact your practice’s reimbursement and payment systems.

Learning Objectives

  • To verbalize key component of CCM
  • To summarize evaluation plan
  • To identify what is needed for the Implementation Plan
  • Review CMS’s Chronic Care Management (CCM) and Principal Care Management (PCM) requirements
  • Examine Scope of Services required to bill Medicare for CCM/ PCM services
  • Identify how CCM can close care gaps and engage patients
  • Identify CCM/ PCM compliance issues
  • Implement Best Practices
  • Assess the financial and quality implications of incorporating CCM in your practice
  • Recognize the importance of CCM in relation to quadruple aim

Areas Covered in the Session

  • History of CCM
  • 2025 – Introduction of the Advanced Primary Care Model (APCM) – New
  • What is Chronic Care Management
  • CCM Activities
  • Patients’ Eligibility
  • Examples of Chronic Conditions
  • Provider Responsibility
  • Initiating Visit
  • Consent – Written or Verbal
  • Consent Template
  • Comprehensive Care Plan
  • CCM Billing
  • Who can bill for CCM?
  • Who can provide CCM
  • Clinical Staff as per CPT and CMS Definition
  • CCM Compliance
  • Know The CCM Rules
  • Principle Care Management (PCM)
  • CCM Platforms Overview
  • Compliance Question
    • Can CCM be provided by physicians/NPPs or staff located outside of the United States?
    • Can you bill 99490 (20 minutes) without a conversation with the patient?
    • Can you have third party doing your CCM?
    • Can CCM services be completely delegated to clinical staff?
    • Do you have to assign each patient to a care team
  • What to look for in the Clinical Team
  • Best Practices
  • Advanced Primary Care Management (APCM)
  • APCM 13 Service Elements
  • Billing for APCM
    • Level 1: HCPCS G0556
    • Level 2: HCPCS G0557
    • Lever 3: HCPCS G0558

Suggested Attendees

  • Nurses
  • Doctors
  • Nurse Practitioner
  • Population Health Officers
  • Innovation officers
  • CNO/ CMO
  • Billers
  • Physicians
  • PCP (MD, NP, PA)
  • Specialists (MD, NP, PA)
  • Nurse Managers
  • C-Suite Healthcare Executives

About the Presenter

Dr. Irina Koyfman, DNP, NP-C, RN, is a Nurse Practitioner and a Doctor of Nursing Practice with 25 years of nursing and 15 years of executive experience. Dr. Koyfman is an expert in the Patient-Centered Medical Home (PCMH), Home Health, Healthcare Start-ups, Transitional Care, Community Health, Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and Care Coordination. Dr. Koyfman is a dedicated and enthusiastic clinician with an entrepreneurial drive. She has a history of establishing 4 successful healthcare ventures, where she drove significant operational growth (up to1,000%), built successful teams with high retention rates, and improved patient satisfaction and patient outcomes. She is a Subject Matter Expert in CCM and RPM, making her a frequent presenter at multiple conferences. As a founder of Affinity Expert, a healthcare consulting company, she has been consulting primary care providers on all aspects of CCM and its successful clinical, operational, and financial implementation. She has created a growing community of clinicians through her CCM/RPM groups on Facebook and LinkedIn where she provides free information and education to providers. She loves to give back and volunteers on multiple boards along with hands on volunteer work.

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