Primary care clinicians drove increasing use of Medicare’s chronic care management codes

To address the problem of care fragmentation for Medicare recipients with multiple chronic conditions, Medicare introduced Chronic Care Management (CCM) in 2015 to reimburse clinicians for care management and coordination. The authors of this study analyzed publicly available Medicare data on all CCM claims submitted nationwide from 2015 through 2018. They compared CCM code usage and paid and denied services across a broad range of medical specialties.

The study showed that CCM use increased over this four-year period, driven largely by primary care physicians. Most claims were billed to the original general CCM code, with newer codes for more complex services accounting for a small portion of overall code usage. The percentage of denied services remained consistent at around 5 percent during this period.

The authors note that a limited number of clinicians currently deliver CCM services and that future work evaluating facilitators and barriers to patients’ and providers’ usage of CCM will be needed.