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Medicare Payment for Chronic Care Delivered in a Patient-Centered Medical Home

Andrew B. Bindman, MD1,3; Jonathan D. Blum, MPP2; Richard Kronick, PhD1
[+] Author Affiliations
1Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC
2Centers for Medicare & Medicaid Services, US Department of Health and Human Services, Washington, DC
3Department of Medicine, University of California, San Francisco
JAMA. 2013;310(11):1125-1126. doi:10.1001/jama.2013.276525.
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Each July, the Centers for Medicare & Medicaid Services (CMS) publishes in the Federal Register its proposals for updating the Medicare physician fee schedule for the upcoming calendar year.1 The rule applies to the approximately 37 million beneficiaries in the fee-for-service program. Following a 60-day public comment period, the CMS finalizes the rule and typically implements it the following January. Although these rules cover a wide range of services, included within the document issued this past July is a little-noticed discussion of Medicare’s intent to make a substantial change in its payment policy. If the rule is finalized as proposed, for the first time physicians would be able to bill Medicare for the non–face-to-face delivery of complex chronic care management services provided by a practice that has the capability to furnish these services.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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