UBC News

Medicare CCM Explained: How To Avoid Billing Mistakes & Boost Recurring Revenue

Episode Summary

Your practice probably already provides chronic care management but isn't getting paid for it. Medicare reimburses CCM services, but most practices struggle with billing requirements and compliance standards that make capturing this revenue difficult. To learn more, visit: https://ccmrpmhelp.com/

Episode Notes

Here's something that might surprise you: your medical practice is probably leaving thousands of dollars on the table every single month. Not because you're doing anything wrong, but because you're doing something right and not billing for it. If you call patients between visits to check on their diabetes management, coordinate with specialists about treatment plans, or help someone understand their new blood pressure medication, you're providing chronic care management. Medicare created specific billing codes to pay you for exactly this work. The catch? Most practices either don't know these codes exist, or they've tried to set up CCM programs and hit a wall of compliance requirements that made them give up. Let's talk about why this happens. The typical story goes like this: a practice hears about CCM revenue opportunities, buys some software, assigns it to a staff member, and expects the money to start flowing. Three months later, they've got denied claims, confused patients, and a team that's ready to abandon the whole thing. The problem wasn't the idea. The problem was trying to build the plane while flying it. Medicare has strict requirements for CCM billing. You need written patient consent using specific language. You must track time precisely, documenting every phone call and care plan update. Your records need to show at least 20 minutes of qualifying activities per patient per month. Miss any of these requirements, and your claims get rejected. Or worse, you get audited later and have to pay everything back. Here's what successful practices do differently: they build the workflows first, then worry about the technology. They establish clear protocols for who does what, how time gets tracked, and where documentation lives. They train their entire team on compliance standards before billing the first claim. It's not exciting work, but it's the work that actually matters. Healthcare consulting specialists who focus on CCM implementation see the same mistakes repeatedly. Practices rush into billing before their systems are ready. They use consent forms that don't meet Medicare standards. They track time loosely instead of precisely. Every one of these mistakes costs real money in denied claims and wasted staff hours. The good news? When you set up your CCM program correctly from the beginning, it becomes a sustainable revenue stream that rewards you for the care you're likely already providing. You just need the right operational foundation to make it work. If your practice wants to explore Medicare-compliant CCM programs without the trial-and-error headaches, check out CCM RPM Help. Visit the link in the description to learn how their consulting services help practices build programs that work. CCM RPM Help City: Herriman Address: 12953 Penywain Lane Website: https://ccmrpmhelp.com/ Phone: +1 866 574 7075 Email: brad@ccmrpmhelp.com