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How PCP’s can Increase Revenue

For some Primary Care Physicians(PCPs), sustaining consistent revenue while juggling care coordination can be a challenge. Luckily enough, the Center for Medicare and Medicaid Services(CMS) has introduced several programs that increase revenue while also improving patient care.

1. Chronic Care Management

Introduced by CMS in 2015, Chronic Care Management (CCM) is a program that doctors still haven’t fully engaged with. CCM is for Medicare patients 65+, struggling with two or more chronic conditions. Once a patient is enrolled in the program, a nurse makes a monthly call to the patient to discuss their care plan created by their PCP. Along with the care plan, the nurse also addresses other needs the patient has, such as refill requests, appointment bookings, and recent hospitalizations. For this service, CMS pays providers $43-$45 per patient, per month. Although CCM helps a practice’s bottom line, the true value in this program is the benefit it offers the patient. Engagement in CCM has proven to reduce hospitalizations and ER visits, while also giving a patient much needed support with their health management.

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2. Annual Wellness Visit

Another program offered by Medicare, the Annual Wellness Visit (AWV) is once a year visit a patient has with their PCP. Primarily, this visit operates a number of screenings, as well as the creation or update of the patient’s personalized prevention plan. This visit isn’t as comprehensive as a full physical, but includes screenings for cognitive impairment, hearing impairment, and depression. CMS pays up to $350 for this yearly visit.

3. Advance Care Planning

Advance Care Planning can be a part of normal office visit or a wellness visit. ACP is for any patients who want to plan for the future if their health worsens. ACP involves a consultation with the patient’s PCP, and the reimbursement usually ranges around $100. ACP is a benefit for both the patient and medical community, giving the patient and their family members a clear understanding of what to do when the unfortunate happens, as well as reducing the large costs of hospice care.

4. Telemedicine

Starting in 2019, CMS will begin to pay for providers who utilize the innovation of telemedicine. Billed as a regular office visit with a modifier, telemedicine can expand PCP’s patient population, especially for younger patients and for those who have difficulty getting transportation to the office. Doctors who engage with telemedicine will likely see a boost in office visits, as well as the opportunity to turn off-hour calls into a billable, live streaming video conference.

To learn more about how you can increase your practice’s revenue, visit us at

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