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CCM Outcomes Agreement Form 2025

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The document outlines a Clinical Care Manager (CCM) Outcomes Agreement, detailing the mutual identification of ongoing needs for a client, including psycho-education, social support, and skill development. It specifies action steps, responsibilities, and due dates to achieve desired outcomes. Additionally, it emphasizes the protection of personal information under privacy laws and includes sections for signatures from the client and care manager.

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Versions	Form popularity	Fillable & printable
2009	4.7 Satisfied (59 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What diagnosis qualifies for CCM?

While most patients enrolled in CCM have one of the five most prevalent chronic conditionsheart disease, cancer, diabetes, obesity, and hypertensionany disease that meets the CMS criteria could qualify.

What does a CCM care plan look like?

A care plan typically includes, but is not limited to: A list of the patients current medical conditions, including the patients prognosis, expected clinical outcomes, and any mental or behavioral illness. Records of symptoms the patient is experiencing.

How do I create a CCM?

Here are ten crucial steps to take when establishing a CCM program: Evaluate the requirements for a CCM program. Explore the resources, infrastructures, and workflows involved in CCM operations. Review patient eligibility. Educate and enroll patients. Develop continuous patient engagement plans.

What are the documentation requirements for CCM?

To bill for Chronic Care Management the following information must be documented in the patients medical record: Patient consent. Comprehensive care plan. Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient.

How do I document CCM?

Patient Consent Before initiating CCM, the patient must provide verbal or written consent, which should be documented in the electronic health record (EHR). Consent must include: An explanation of CCM services and the patients eligibility. Cost-sharing details, including co-pays and deductibles.

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How do I bill for CCM?

CCM services provided by a physician or other qualified health care professional are reported using CPT code 99491 and require at least 30 minutes of personal time spent in care management activities.

Does Medicaid pay for CCM?

Medicare and Medicaid reimburse providers who offer CCM programs, because these programs reduce patient costs and healthcare spending by an average of $2,457 per patient.

CCM Outcomes Agreement Form 2025

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See more CCM Outcomes Agreement Form versions

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Got questions?

What diagnosis qualifies for CCM?

What does a CCM care plan look like?

How do I create a CCM?

What are the documentation requirements for CCM?

How do I document CCM?

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How do I bill for CCM?

Does Medicaid pay for CCM?

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