When CPT developed and CMS recognized chronic care management (CCM) codes, many primary care groups looked at the requirements and took a pass. Even after CMS relaxed the requirements, it seemed too complicated and difficult for the reimbursement level.
But, this article is going to look at Care Plan Oversight (CPO) codes not CCM.
CPT and CMS codes for Care Plan Oversight
There are two sets of Care Plan Oversight codes, CPT and HCPCS codes.
Medicare recognizes and pays for the HCPCS codes.
Commercial payers are more likely to recognize and pay CPT codes, although there is no guarantee that they will consider it a covered service. That is the first complexity of CPO.
Not only are there two sets of codes, but the time requirements for the two sets are different.
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