Chronic Care Management

Insufficient documentation causes most improper payments. Insufficient documentation means that something was missing from the medical records.  Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for CCM services: 

• • Missing documentation that support CCM was performed;
  • Missing CCM care plan with documentation that it was provided to the beneficiary or beneficiary’s caregiver;
  • Missing patient agreement or consent for CCM;
  • Missing electronic signature or legible signature of the performing provider

Related Content

• • Care Management: fact sheets, frequently asked questions, and information on chronic conditions in Medicare
  • MLN Booklet®: Chronic Care Management Services
  • Connected Care Toolkit: Chronic Care Management Resources for Health Care Professionals and Communities
  • YouTube Video:   Connected Care: Physician Testimonial about Chronic Care Management
  • Centers for Medicare & Medicaid Services Internet-Only Manual, Publication 100-8, Medicare Program Integrity Manual, Chapter 3, (Signature Requirements)

Reviewed 11/14/2024