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TRICARE Policy Manual 6010.60-M, April 1, 2015
Chapter 1
Section 14.2
Chronic Care Management (CCM) Services
Issue Date:  August 19, 2015
Authority:  32 CFR 199.4(g)(1)
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
1.0  CPT Procedure Code
2.0  Description
2.1  CCM services -- at least 20 minutes of clinical staff time directed by a physician or other qualified healthcare professional, per calendar month, with the following required elements:
•  Multiple (two or more) chronic conditions expected to last at least 12 months or until death of the patient;
•  Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; and
•  Comprehensive care plan established, implemented, revised, or monitored.
2.2  CCM reflects services provided over a monthly period to specified patients with chronic health conditions who have consented to receipt of such services.
3.0  Policy
CCM services are not covered by TRICARE because the services are not medically necessary as a separately itemized service.
4.0  Effective Date
January 1, 2015.
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