Profitability With InXite’s Chronic Care Management System

Today, approximately 117 million people – about half of all adults – suffer from one or more chronic health condition and one in four adults have two or more chronic health conditions, such as asthma, diabetes and congestive heart failure. Although these are some of the most common illnesses among the population today, they are becoming more and more manageable due to preventative measures taken by both physicians and healthcare entities as well as patients.

With the introduction of CPT code 99490 on January 1, 2015, CMS began reimbursing for chronic care management services for qualified Medicare beneficiaries with chronic health conditions that can become more controllable with guidance and close interactions with a dedicated care team. The reimbursement rate for providing these additional care management services is an average of $43 per member per month (PMPM). Many chronic care management programs offer features such as beneficiary medication reconciliation, patient-centered care plans, 24/7 access to care management services, and more. New codes are added and rules are updated each year.