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Enhanced Care Management 1

If not, we refine the recommended PE inputs to better reflect our estimate of the PE resources required for the service

The services that trigger an event for these chronic condition episode-based measures are identified first by Evaluation and Management (E/M) codes for outpatient services, and then by a second claim with either another E/M code for outpatient services or a condition-related Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) code (CPT/HCPCS) related to the treatment or management of the chronic condition

Together, this raises your risk of stroke

not maintained or updated to reflect current clinical guidelines, which are not reflective of a clinician's scope of practice