Iowa Healthcare Collaborative

Billable Medicare Services

Annual Wellness Visits (AWV)


Medicare Learning Network (MLN) Educational Tool: The ABCs of the Annual Wellness Visit (PDF)

Centers for Disease Control and Prevention: A Framework for Patient-Centered Health Risk Assessments (PDF)

Quality Insights (Link)
Quality Innovation Network-Quality Improvement Organization (QIN-QIO) has put together a comprehensive toolkit for Annual Wellness Visits.

Transitional Care Management (TCM)


Transitional Care Management (PDF)
CMS document describing Transitional Care Management.

CMS Frequently Asked Questions about Billing the Medicare Physician Fee Schedule for Transitional Care Management Services (PDF)

American College of Physicians (ACP): What Practices Need to Know About Transitional Management Codes (Link)

Chronic Care Management (CCM)


Connected Care: The Chronic Care Management Resource (Link)
CMS has gathered their Chronic Care Management resources onto one website.

CMS Guidance on Chronic Care Management Services
Published December 2016.

Rural Health Clinics (RHC) and Federally Qualified Centers (FQHC)

CMS Frequently Asked Questions about Physician Billing for Chronic Care Management Services (PDF)
Published November 2017.

Chronic Care Management (CCM) Toolkits and Resources

Connected Care, the Chronic Care Management Resource: Health Care Professional Toolkit (PDF)
This toolkit was developed by CMS and has interactive links for additional resources.

American College of Physicians Chronic Care Management Toolkit: What Practices Need to Do to Implement and Bill CCM Codes (PDF)
Published 2017.

Medication Safety Learning and Action Network (LAN) Event: What Can Chronic Care Management Do For You (Link)
This webinar has an excellent example of how an organization implemented Chronic Care Management.

Patient Consent Form Examples

Chronic Care Management (CCM) Checklist for Patient Consent - Telligen and the American Pharmacists Association (PDF)

Chronic Care Management Patient Agreement - Capture Billing and the American Pharmacists Association (PDF)

Advance Care Planning


Medicare Learning Network: Advance Care Planning (PDF)

Frequently Asked Questions about Billing the Physician Fee Schedule for Advance Care Planning Services (PDF)

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