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The Managed Care Support (MCS) Manuals (T-3) for contracts prior to 07/21/2016 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each T-17 manuals' web page.
Administration
Chapter 1
Section 14.2
Chronic
Care Management (CCM) Services
Issue Date: August 19, 2015
Copyright: CPT only © 2006 American Medical
Association (or such other date of publication of CPT). All Rights
Reserved.
Revision:
1.0 CPT Procedure Code
99490
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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