Comprehensive Care Management (CCM) Tariffs

Questions & Answers

On April 1, 2012 tariffs for Chronic Disease Management (CDM) were established. These tariffs continue to be available for all family physicians. Effective April 1, 2017, family physicians with an EMR can claim new tariffs for Comprehensive Care Management (CCM).

Question Answer
When do the Comprehensive Care Management Tariffs take effect? April 1, 2017 (some exceptions noted below).
Do I require an EMR in order to claim these tariffs? Yes.
What if I do not use an EMR? You may continue to claim Chronic Disease Management tariffs.

If you do not have an EMR but are interested, we recommend you review in the information posted at the Manitoba eHealth website www.manitoba-ehealth.ca/emr-cert/ or contact their Primary Care/Community Information Systems (PCIS) Office at (204) 926-3842 or email EMR@manitoba-ehealth.ca

Is my billing software alone sufficient to claim these tariffs? No.
Does the EMR have to be certified Manitoba Health/e-Health? No.
Does my EMR require specialized programming or modifications? Possibly, you should check with your EMR Vendor.
Why do I need an EMR? The documentation of patient enrollment and communication of services provided to Manitoba Health through an EMR is a requirement of the tariffs.
What is required for patient enrollment? Discussion between the patient and physicians confirming the physician and her/his team is the patient’s most responsible primary care provider and document enrollment.
Does the patient have to sign a form to confirm enrollment? No.
If my patient seeks episodic care elsewhere such as a walk-in clinic will I still be able to claim CCM? Yes.
Can I claim Chronic Disease Management (CDM) tariffs on some patients in my practice and CCM tariffs on other patients? Yes.
I currently claim the Chronic Disease Management tariffs on my patients in June of each year and plan to switch to CCM, can I bill these tariffs on April 1, 2017? Manitoba Health’s Claims Processing System (CPS) will only allow CDM or CCM for a patient every 12 months. In this example, you will have to wait until June 2017 to claim.
What ICD code do I use for tariff 8456 (2 diseases) and 8458 (3 diseases)? Use any 1 of the specified ICD codes that you are providing care for on that patient, e.g., Asthma, Diabetes.

Questions?

Roger Jamieson
rjamieson@docsmb.org
(204) 985-5849

 

Updated: December 2016