HealthArc

09/15/2025

What You Need to Know About CPT 99487

Complex Chronic Care Management (CCCM) services are essential for patients with two or more serious chronic conditions. CPT 99487 covers the additional time, planning, and decision-making required to support this high-risk population.

In our latest guide, we explain:
• Eligibility criteria for 99487
• Billing rules and restrictions
• The difference between 99487 and 99490
• Average reimbursement and compliance tips

Help your practice reduce readmissions and optimize revenue.
Read here: https://www.healtharc.io/blogs/all-about-cpt-99487-complex-chronic-care-management/

#99487

CPT Code 99487 is the Medicare billing code for Complex Chronic Care Management (CCCM) services for patients with multiple chronic illnesses.

09/13/2025

Need Help Billing CPT 99495 for Transitional Care?

Transitional Care Management (TCM) codes like 99495 help providers support patients after hospital discharge—but they come with strict timing, face-to-face requirements, and billing restrictions.

This HealthArc guide covers:
• Who can bill 99495
• What documentation is needed
• $203 average reimbursement
• When it can (and can’t) be billed
• Compliance tips for 2024

Perfect for providers, billers, and practice managers.

Learn more: https://www.healtharc.io/blogs/cpt-code-99495-for-billing-transitional-care-management-tcm/

#99495

CPT code 99495 is one of the two TCM codes allowing providers to document and report TCM services for medical decision making of moderate complexity.

09/08/2025

Reduce Hospital Readmissions by 20% with Transitional Care Management

Did you know that nearly 1 in 5 patients is readmitted within 30 days of discharge, costing healthcare systems billions? The solution: Strategic Transitional Care Management (TCM).

What TCM Delivers:
• Seamless care transitions from hospital to home
• Required contact within 2 business days post-discharge
• Face-to-face visits within 7-14 days based on complexity
• Comprehensive medication reconciliation
• Coordinated care among all providers

Financial Impact:
• Medicare reimbursement: $160-170 (moderate complexity) / $230-240 (high complexity)
• Significant reduction in costly readmissions
• Improved patient satisfaction scores
• Enhanced care quality metrics

Key CPT Codes:
• 99495: Moderate complexity decision-making
• 99496: High complexity decision-making

Perfect for: Healthcare providers, care managers, and organizations looking to improve post-discharge outcomes while maximizing reimbursement opportunities.

The Bottom Line: TCM isn't just about compliance—it's about creating a bridge that ensures patients successfully transition from hospital to home, reducing readmissions and improving lives.

Ready to implement TCM in your practice?

Read our complete guide ⬇ https://www.healtharc.io/blogs/a-complete-guide-to-transitional-care-management-tcm/

Explore transitional care management (TCM) in healthcare guidelines, CPT codes, and requirements for seamless healthcare transition.

09/06/2025

CMS 2026 Just Reshaped Telehealth

Medicare’s proposed 2026 rules make virtual care more permanent than ever—no more frequency caps, clearer billing for 2–15 day RPM blocks, and expanded digital therapy coverage.

If you're running remote monitoring or behavioral health programs, this blog breaks down what’s changing in:
• Virtual supervision
• CPT fee schedules
• Audio-only allowances
• RPM & CCM workflows

See what’s coming and how to prepare your practice: https://www.healtharc.io/blogs/how-cms-2026-medicare-proposed-rules-will-affect-telehealth-rpm/

09/05/2025

The Complete Remote Patient Monitoring Guide for 2025 is Here!
Transform your healthcare practice with the power of RPM technology. Our comprehensive guide covers everything you need to know to implement successful remote monitoring programs:

What's Inside?
• How RPM works: From device setup to data analysis
• 2025 CMS billing rates & CPT codes (99453, 99454, 99457, 99458, 99091)
• Latest Medicare policy updates and reimbursement strategies
• Top 5 RPM devices: Blood pressure cuffs, glucometers, pulse oximeters & more
• Real benefits for both patients AND providers

Key Benefits You'll Discover:
• Reduce hospital readmissions by up to 38%
• Improve patient engagement with chronic disease management
• Generate sustainable revenue streams with proper billing
• Enhance care delivery without increasing office visits

Market Reality Check: The RPM market is projected to reach $117.1 billion by 2025. Are you positioned to capture this opportunity?
Perfect for: Healthcare providers, practice managers, and anyone looking to implement or optimize their RPM programs in 2025.
Ready to revolutionize your patient care delivery?

Here is the complete guide ⬇https://www.healtharc.io/blogs/remote-patient-monitoring-a-complete-guide-by-healtharc/

What is RPM and how does it work in 2025? Learn about CPT billing codes, key devices, and benefits for providers and patients in this updated guide.

09/04/2025

Are you aware of the revenue generation opportunity from Chronic Care Management programs?

Here's what every healthcare provider needs to know about Medicare Advantage (MA) reimbursement:

Key Insight:
•MA plans are REQUIRED to provide the same CCM coverage as Original Medicare
•Financial Impact: MA plans reimburse CCM services just like traditional Medicare Part B
•Coverage Details: Some MA plans even cover Part B premiums, reducing patient costs

What This Means for Your Practice:
•Expanded patient eligibility for CCM services
•Predictable reimbursement rates across MA and Original Medicare
•Opportunity to serve dual-eligible patients with Medicaid covering cost-sharing

The Bottom Line: Understanding MA reimbursement policies are crucial for maximizing your CCM program's financial sustainability while improving patient outcomes.

Are you ready to optimize your CCM billing strategy?

Read our complete guide to Medicare Advantage CCM reimbursement ⬇ https://www.healtharc.io/blogs/reimbursement-for-ccm-what-medicare-advantage-ma-plans-include/

Chronic care management (CCM) is covered as part of Medicare Part B and is reimbursable under Medicare Advantage. Read our blog post to know more.

09/02/2025

Your Complete Guide to Remote Patient Monitoring in 2025

Everything healthcare providers need to know about RPM - from setup to reimbursement.

What's Inside?
• Updated 2025 CPT codes & reimbursement rates
• 5 essential RPM devices (blood pressure cuffs, glucometers, pulse oximeters)
• Step-by-step billing guidelines for Medicare compliance
• Patient benefits - convenience, better outcomes, cost savings

Key Takeaways: → RPM market projected to reach $117.1B by 2025 → 16-day minimum usage required for billing → Only one provider can bill RPM per patient per month → HIPAA compliance is mandatory

2025 Reimbursement Rates:
• Setup (99453): $19.73
• Monitoring (99454): $43.03
• Management (99457): $47.87
Perfect resource whether you're starting an RPM program or optimizing your current setup.

Read the complete guide: https://www.healtharc.io/blogs/remote-patient-monitoring-a-complete-guide-by-healtharc/

What's your biggest RPM implementation challenge?

What is RPM and how does it work in 2025? Learn about CPT billing codes, key devices, and benefits for providers and patients in this updated guide.

08/30/2025

How Does HealthArc Compare to RPM Software-Only Tools?

From built-in clinical staffing to cellular devices and billing automation—HealthArc offers a full-service model that simplifies remote care.

This new blog compares it with RPM software solutions like Prevounce, Nsight, and ChronicCareIQ, showing what each model offers for implementation speed, scalability, EHR integration, and ROI.

A must-read if you're evaluating RPM vendors.
https://www.healtharc.io/blogs/healtharc-platform-vs-rpm-software-solutions/

Compare HealthArc’s full-service RPM platform with leading software-only solutions. Find the best fit for your team, budget, and patients.

08/28/2025

Transforming chronic care from operational expense to strategic asset...

There's a critical difference between enhancement and infrastructure approaches that determines your program's success or failure.

🔄 Enhancement Approach:
• Adds RPM tools to existing workflows
• Depends on current staff to manage additional tasks
• Creates operational burden on top of regular duties
• Results: Heroic individual efforts, unsustainable scaling

⚡ Infrastructure Approach:
• Rebuilds workflows around systematic economic capture
• Automates compliance, risk stratification, and engagement
• Creates dedicated pathways for reimbursable activities
• Results: 76% report positive patient care impact, 70% improved satisfaction

Here's the reality: With 60% of adults having chronic conditions and 40% having multiple conditions, enhancement approaches collapse under volume. They're simply not designed for population-scale management.

Infrastructure approaches handle the reality of systematic management of entire patient populations, not just motivated individuals.

Enhancement thinking asks: "How do we add chronic care services?" Infrastructure thinking asks: "How do we systematically optimize chronic care economics while improving outcomes?"

One creates expenses. The other creates strategic assets with predictable revenue streams, scalable operations, and competitive differentiation.
The organizations building sustainable competitive advantages understand this distinction.

08/27/2025

$50 Billion for Rural Health. Is Your RPM Program Ready?

Signed on July 4, the “One Big Beautiful Bill” unlocks the biggest federal investment in digital health since the pandemic—$50B over 5 years.

But it’s not automatic. To benefit, providers must act before key deadlines and policy cliffs.

Learn what this means for:
1. Remote Patient Monitoring funding
2. Medicaid impacts and state-specific grants
3. Reimbursement strategies beyond 2025

HealthArc’s expert blog outlines what to do now to build sustainable RPM programs: https://www.healtharc.io/blogs/how-can-one-big-beautiful-bill-boost-rpm-programs-by-50b/

The $50B “One Big Beautiful Bill” boosts RPM in rural healthcare. Learn funding details, deadlines, risks, and how providers can prepare for 2025–2030.

08/27/2025

What’s Changing in Principal Care Management for 2026?

For clinics treating patients with a single chronic condition, PCM is now a powerful path to better outcomes and CMS-aligned reimbursement.

Our latest blog covers CPT codes 99424–99427, how to meet documentation requirements, and how PCM fits with your existing RPM and CCM workflows.

Read the full guide from HealthArc and stay ahead of Medicare updates: https://www.healtharc.io/blogs/principal-care-management-pcm-2026-cpt-codes-workflows-medicare-updates/

Explore 2026 Medicare PCM guidelines. Learn how Principal Care Management supports patients with one chronic condition, CPT codes, and reimbursement rates.

08/26/2025

Healthcare CFOs are discovering a game-changing perspective on chronic care management success.

It's not just about clinical outcomes anymore – the real measurement is systematic economic performance.

What CFOs are tracking now:
• $1,560 average annual savings per patient (Health Affairs study)
• 85.5% Medicare reimbursement rates with structured teams
• $300 billion potential annual healthcare cost savings nationwide
• 90% of healthcare executives report positive ROI from systematic RPM programs

Here's what CFOs understand that clinical teams often miss: Traditional chronic care programs create operational expenses that depend on individual provider heroics. Infrastructure-focused programs create systematic revenue streams with predictable, scalable economics.

When you build economic architecture first—automated compliance tracking, optimized reimbursement capture, systematic workflow management—you transform chronic care from a cost center into a profit-generating asset.

The CFOs leading this transformation aren't asking "Are we providing better care?" They're asking "Are we systematically capturing reimbursable value while improving outcomes?"

That's infrastructure thinking. And it's what separates sustainable programs from costly experiments.