Care Select care coordination conferences

Following the March 14th ISMA Medicaid Coalition meeting, Chris Kerns of MDwise and Kelvin Orr of Advantage Health Solutions provided clarification on the Care Select care coordination conferences.  The care coordination conference is a meeting between a care manager and primary medical provider (PMP).  It is a forum for discussion of patients’ plans of care.  The conferences will generally last about an hour and several patients may be discussed during each conference. 

The coordination conference is billed using 99211 SC (office or other outpatient visit for the evaluation and management of an established patient, SC-medically necessary service or supply) and is limited to two per calendar year, per Care Select member.  The PMP may bill 99211 SC for each member included in the conference.  The current reimbursement for 99211 SC is $40. 

The Care Select PMP may allow a nurse practitioner in the same group to perform the care coordination conference service. The nurse practitioner must use the unique rendering provider number associated with the Care Select PMPs group number, or if the nurse practitioner is not enrolled in the IHCP with a provider number, the SA modifier (SA-Nurse Practitioner rendering service in collaboration with a physician) must be appended to the service.

Further information can be found in IHCP bulletins BT200723 and BT200804.