The Medicare Physician Fee Schedule Final Rule provides substantial payment increases for Medicare Out-of-office Care Management Services effective January 1, 2022. For example, the reimbursement for the CPT Code 99490 increased on average from $42 to $64, representing a 51% increase.
To provide perspective, this new policy means that a practice enrolling 300 eligible Medicare patients to CareTrack’s system has the potential to gross more than $225,000 in yearly revenue from CPT Code 99490 alone. Creating this profitable revenue stream helps offset the adverse financial effects of disruption and payment reductions that contribute to physician and practice staff burnout.
Why this payment incentive?
Medicare has always fully intended eligible beneficiaries to enroll in Patient Adherence Solutions. Surprisingly, there has been slow adoption, low patient enrollment, and unexpected refractoriness to participating in these services, even though it has many benefits for both practices and patients. A 2015 survey revealed that many of the challenges were due to physicians being uninformed of the program’s benefits and believing that Medicare reimbursements were too low.
Why implement CareTrack Health’s Patient Adherence Solution?
Based on an ROI/gap analysis, most medical practices lack the resources and capabilities required to implement a profitable, high-value patient adherence program. CareTrack Health is THE solution for practices to overcome this issue.
2022 Average Reimbursement Rate Increase
| Codes | Reimbursement Increase | 2022 | 2021 |
| CPT 99490 | +$23.61 | $65.61 | $42 |
CareTrack Health’s Patient Adherence System enhances patient satisfaction, saves Medicare dollars, helps primary care practices increase revenue and efficiency, and, most importantly, improves the lives of the Medicare patients who entrust doctors with their care every day.