08/18/2026

ASCO’s August 2026 Coding Tip of the Month: Navigating Care Management Services

As oncology care increasingly emphasizes continuous, coordinated support, care management services—including Chronic Care Management (CCM), Complex Chronic Care Management (CCCM), and Principal Care Management (PCM)—have become essential for managing high-risk patients. However, with the Office of Inspector General (OIG) launching an audit focusing on Medicare payments for CCM services at risk of noncompliance, oncology practices should proactively review their billing and documentation workflows. Utilizing ASCO’s newly updated Care Management Services: Practice Administration Guide can help practices align their clinical workflows with payer expectations and reduce the risk of claim denials.

To ensure compliance under heightened audit scrutiny, providers should know and implement the following key principles:

• Understand Time Requirements:  The minimum time requirement in the code description should be fully met.
• Document and Share the Care Plan: Practices should establish a comprehensive, personalized care plan addressing patient needs, and a copy should be provided to the patient or caregiver.
• Secure Patient Consent: Before billing, practices should obtain and document the patient's consent, ensuring they understand their right to terminate services and are aware of any potential cost-sharing.
• Avoid Overlapping and Duplicate Billing.

Stay up-to-date on ASCO's Coding and Reimbursement page.