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BCBSM Provider-Delivered Care Management

(Updated January 9th, 2019)

Blue Cross Blue Shield of Michigan Provider-Delivered Care Management

Provider-Delivered Care Management (PDCM) is part of Blue Cross Blue Shield of Michigan’s Patient-Centered Medical Home program, which is a core element of Value Partnerships’ Physician Group Incentive Program.

Provider-Delivered Care Management involves the delivery of care management services by a care manager working with a physician and care team in an eligible primary care or specialist office.

All Blue Cross PCMH-designated physicians are eligible to bill Blue Cross for PDCM services, as well as non-designated practices participating in the Comprehensive Primary Care Plus (CPC+) initiative. Providers who participate in PDCM receive reimbursement for care management services rendered through 12 procedure codes.

Blue Cross Blue Shield of Michigan

Provider-Delivered Care Management Training Requirements

January 2019

 

Role

What Training is Needed?

Who can deliver the training?*

Care team members that deliver the G9001 code

  • Complex care management training
  • PDCM online billing course
  • 8 hours of continuing education per year, pro-rated based on when care team member started billing PDCM services
  • CCM can be delivered by any training entity in the state that is approved by MICMT
  • Online billing course available at https://micmrc.org/
  • Continuing education can be delivered by PO, MiCMRC, or independent training body

Care team members that deliver the other 11 PDCM codes

  • Complex care management training OR self-management support training (selection is at PO/provider/care team discretion and should be based on preference, interest, role in the practice, etc.)
  • PDCM online billing course
  • 8 hours of continuing education per year, pro-rated based on when care team member started billing PDCM services
  • CCM and self-management support training can be delivered by any training entity in the state that is approved by MICMT
  • Online billing course available at https://micmrc.org
  • Continuing education can be delivered by PO, MiCMRC, or independent training body

*If you are unsure about whether your preferred training vendor is approved, or to submit your training entity for approval to deliver training, please contact MiCMRC by clicking here

*For a list of approved self-management support courses, click here

2019 Coming Soon:

Please submit questions: valuepartnerships@bcbsm.com

For more information on CPC+ please refer to the BCBSM CPC+ FAQ

 

Course Information:

Note:  For Care Management Billing Resources Click Here.

For questions regarding courses or for additional information, please contact micmrc-requests@med.umich.edu