The title makes it all clear, right? No? I didn’t think so. This article is an overview of  CMS’s Ambulatory Specialty Model. CMS is implementing a mandatory, disease-specific reporting model beginning in the CY 2027, reporting due March 31, 2028. Who will be required to report?  And for what conditions? Physicians who work in the […]
Care Management Services
Remote Physiologic Monitoring Treatment Management Services
The remote physiological monitoring section describes providing equipment and data collection, initial set up and education on the use of the equipment, and treatment management based on the data that was measured. The codes are confusing because they are sorted/divided in confusing ways. Codes 99453, 99445 and 99454 are for the initial set up and […]
Remote Therapeutic Monitoring
There are two sets of codes in the CPT® code set for Remote Therapeutic Monitoring (RTM). The first set is for the monitoring itself, and includes codes for initial set-up and patient education and for the device supply or data transmission. The second set of codes is for treatment management services based on the data […]
Remote Monitoring Management 99091, 99457 | Reference Sheet
This quick reference sheet includes descriptions and examples for CPT ® codes 99091 and 99457-99458 for reporting Remote physiologic monitoring treatment management services.
Remote Monitoring 99453, 99454 | Reference Sheet
CPT codes 99453 99454 are used to report remote monitoring device set up, supply and recording. This resource answers the questions: who does the work, what is being monitored, how is it done, and what does the practice do.
Checklist for CPT® code 99483 | Cognitive Assessment Code for Dementia
Is your practice performing cognitive assessments for patients with dementia, using CPT® code 99483? If so, use this checklist to make sure you have documented all of the required components.
Coding for Telehealth
In this article: Telehealth and Extended Flexibilites – Feb, 2026 Telehealth Prior to the Pandemic Current Telehealth Rules Important Details (modifiers, frequency, teaching physicians, and more) RHCs and FQHCs Place of Serivce CPT® Codes for Telehealth Is it or isn’t it a Telehealth Service Communication-Based Technology Services Telehealth Flexibilities Extended Until Dec. 31, 2027! Date […]
Consent for Communication Technology-Based Services (CTBS)
Both CPT® and CMS have developed codes for non-face-to-face communication-based technology services (CTBS) in recent years. In addition to care management services, these include interprofessional consults, remote physiologic and therapeutic monitoring, and on-line digital E/M services In the 2020 Physician Fee Schedule Final Rule, CMS clarified the type of patient consent that is required to […]
Blood Pressure Self-Measurement 99473, 99474 | Reference Sheet
CPT ® codes 99473 and 99474 are used to report specific clinical staff and/or Physician, NP or PA work related to blood pressure self-measurement by patients. This quick reference sheet defines the work, the time required, and lists the criteria for reporting these services.
Coding for Medical Nutrition Therapy Services
Medical Nutrition Therapy Services (MNT) have been a covered benefit under Medicare since the early 2000’s. This article will describe the rules related to coding for medical nutrition therapy services for Medicare patients. This article also addresses common questions about coverage under the Medicare benefit with brief answers and links to the source documents for […]
Outpatient Diabetes Self-Management Training (DSMT) Services
Medicare covers diabetes self-management training (DSMT) services are a covered benefit under Medicare when all requirements are met. This article will provide an overview of the requirements and provide answers to some commonly asked questions. It will also provide you with links to the source material for DSMT coverage in the CMS Medicare Benefit Policy […]
Psychiatric Collaborative Care Management Services
This resource covers Psychiatric Collaborative Care Management Services 99492, 99493, 99494 and Care Management for Behavioral Health 99484.
Coding Guide – Care Management Services
Updated December, 2025
Coding Guide – Advanced Primary Care Management
Care management services have played an increasing role patient care management. CMS and other payers no longer pay only for face-to-face services, a concept that would have been unthinkable 15 years ago. CMS began paying for Transitional Care Management Services in 2013, for chronic care management services in 2014. In the 2016 Final Rule, CMS […]
Chronic Care Management | Reference Sheet
This quick reference sheet includes clinical staff time, care planning and billing practitioner work criteria for chronic care management services. When coding for care management services services, practitioners need to distinguish between chronic care management and complex chronic care management, between who does the work, the practitioner or clinical staff, and the amount of time […]
Care Plan Oversight | Coding reference sheet
There are two sets of codes for care plan oversight, CPT® (99374–99380) and HCPCS codes (G0181, G0182). The requirements for each are different, including time thresholds and what activities may be included in the CPO time. RVUs are assigned by Medicare for these CPT® codes. Some have a bundled indicator and some invalid, which means […]
Advance Care Planning Q&A
Does your practice provide Advance Care Planning (ACP) services? If so, read on and watch the video below. Q:Â Can it be billed as a group service? A:Â No. It is a service to an individual beneficiary and/or their family member(s) or surrogate. Q:Â Does it follow the mid-point rule? Should I start to bill 99497 at 16 […]
Care Management Services | Webinar
Recorded October 30th, 2025
1 CEU expires 10/30/26
Guest presenter Pam Warren of MaineHealth
Care management services include Transitional Care Management, Chronic Care Management, Principal Care Management and Advanced Primary Care Management. Each type of care management has its own purpose and service requirements.
Fueling Compliance: Cracking the Code on DSMT & MNT | Webinar
Recorded June 26th, 2025
1 CEU expires 6/30/26
Guest presenter Darren Goodwin of MaineHealth
Join us for an overview of Diabetes Self-Management Training (DSMT) and Medical Nutrition Therapy (MNT) services., outlining key coverage criteria, provider qualifications, and documentation requirements.
CMS Adopts Codes for Caregiver Training Services (CTS)
This is information from the 2024 Physician Fee Schedule Final Rule, published Nov. 2, 2023. You can read it for yourself by downloading the pdf below. 2024 Physician Fee Schedule Final Rule, published Nov. 2, 2023 MLN Matters article Jan. 2024 – PDF These are not on the telehealth list; they are in person services […]
Interprofessional Internet Consultations
CMS recognizes and pays for six codes for interprofessional consults codes 99446–99449, 99451, 99452 See also HCPCS codes developed in 2025 for behavioral interprofessional consults | G0546–G0551 These codes were updated in 2023. Codes 99446, 99447, 99448, 99449 and 99451 may now be performed by physicians and other qualified health care professionals. Because these codes […]