Patient Centered Medical Home Program Updates March 12, 2019
Care Plan Dates --- We strongly encourage practices to develop care plans for high-risk members. However, as of January 1, 2019, the dates are no longer required to be entered in your
My Account provider portal at QualChoice.com.
PMPM Payments ---Effective January 1, 2019, quarterly per member per month PCMH payments will be transmitted on a separate provider remittance advice.
Quality Ratings Reminder ---Data must be submitted for eCQM measures. Category II CPT codes may be submitted for reporting of quality data. Practices unable to submit Category II codes may send supplemental data files.
Effective January 1, 2019, QualChoice now covers transitional care management services. These services may be required for patients who are discharged from a facility stay, to help with the transition back to their usual living situation and decrease the likelihood of readmission.
Review details in Provider Manual.