A physician employment agreement is the contract that sets the pay, duties, length, and exit terms when your practice hires a doctor as an employee. For an independent practice, it is also the single document that decides whether a new hire strengthens the practice or quietly drains it. Most practices get one part wrong. They…
How PMC designed an in-house PCM and RTM program for its affiliated clinic, built so the practice’s own staff run it.
What a care coordinator job description must contain for a medical practice that bills Medicare care management: duties, credentials, supervision and employment status.
Reviewed by Jack Wright, Managing Partner To bill for chronic care management, you need six things in place before the claim goes out: an initiating visit for any patient you have not seen in a year, documented consent, an eligible patient with two or more qualifying chronic conditions, an electronic comprehensive care plan, at least…
Medicare applies a two-part test, not a list of diagnoses. Here are the criteria, the fourteen conditions CMS names, and the boundaries that point to PCM or APCM instead.
What chronic care management companies do, how they price it, where the compliance exposure actually sits, and the nine questions to ask before signing.
Chronic care management is a Medicare benefit that pays your practice a monthly fee for the care your team already delivers between office visits. If a patient has two or more chronic conditions and a member of your clinical staff spends at least 20 minutes in a calendar month coordinating that patient’s care, Medicare pays…
This calculator compares two ways to run Medicare care management: through an outsourced vendor, or staffed by your own team. Enter your enrolled patient counts, what your vendor charges, and what your own staffing would cost. It returns estimated monthly and annual program revenue at 2026 Medicare national rates, and the net under each model….
CMS has proposed that from January 1, 2027, RPM and RTM may be billed only when clinical staff directly employed by the billing practice furnish the service. If your program runs through a third party vendor and the rule finalizes as written this fall, you will have roughly eight weeks between the final rule and…
Remote therapeutic monitoring bills in three layers: a one-time setup code (98975, $21.71), a monthly device supply code set by therapy type and by how many days data came in, and monthly treatment management (98979, 98980, 98981). RTM tracks therapy adherence and response at home across musculoskeletal, respiratory, and cognitive behavioral therapy monitoring, and like…
