BCBSM Provider-Delivered Care Management

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BCBSM PDCM-Specialists

(Updated January 15th, 2019)

Provider Delivered Care Management for Specialists

All specialist physicians are able to bill for Provider-Delivered Care Management services, as long as they meet the criteria set forth by Blue Cross Blue Shield of Michigan (exact criteria TBD).

 

There is no value-based reimbursement associated with the PDCM-specialist program. For details about the criteria to participate in the PDCM-specialist program, please see the PDCM Frequently Asked Questions document, available by emailing valuepartnerships@bcbsm.com.

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

Note: For Care Management Billing resources Click Here

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