CCP CCM Billing & CMS Guidelines 2

Question 1

CPT code 99491 differs from 99490 in that it requires the billing provider to personally perform at least how many minutes of CCM services?

Accepted Answer

20 minutes

Answer

CPT 99491 requires the physician or qualified NPP to personally perform at least 20 minutes of clinical staff or direct CCM time per calendar month.

Question 2

Which CPT code is used to bill for each additional 20 minutes of complex CCM services beyond the first 60 minutes?

Accepted Answer

99489

Answer

CPT 99489 is the add-on code for each additional 30 minutes of complex CCM time beyond the initial 60 minutes billed under 99487.

Question 3

Under CMS rules, which of the following services CANNOT be billed on the same day as a CCM service by the same provider?

Accepted Answer

Transitional Care Management (TCM)

Answer

CCM cannot be billed during the same month a TCM service is billed because TCM time counts toward CCM and the services overlap.

Question 4

Medicare's CCM benefit requires that a care plan be based on a physical, mental, cognitive, psychosocial, functional, and environmental assessment — known collectively as what?

Accepted Answer

Comprehensive care plan

Answer

CMS requires a comprehensive care plan that addresses all domains listed and is electronically shared with other treating providers.

Question 5

A CCM patient calls the practice at 8 PM on a Friday with a non-urgent question. The care coordinator spends 7 minutes answering. How does this time count for billing?

Accepted Answer

It counts toward the monthly CCM time log

Answer

All non-face-to-face clinical time related to CCM, including after-hours calls, counts toward the monthly time log as long as it is documented.

(CCP) Chronic Care Professional Certification Practice Test

(CCP) Chronic Care Professional Certification Practice Test

CCP CCM Billing & CMS Guidelines 2