AfyMD Chronic Care Management Services

AfyMD offers a turn-key solution for practices, allowing you to receive your CCM revenue. The program provides a Call Center of trained and certified medical assistants who:

Conduct chronic care phone calls with your patients each month

Document the calls appropriately and securely in your EHR

What do I need to do

20 minutes of non face-to-face chronic care services

Medicare patients with 2+ chronic conditions will be eligible

Only one providing physician may bill

Services can be billed every month

Services can be billed every monthUse a certified EHR – MU I or MU II (if you don’t currently have one, don’t worry – we do!)

Services can be billed every monthEnsure beneficiary 24/7 access to care plan via a Patient Portal (we have one of those, too!)

Facilitate transitions of care or follow-up after ER or hospitalization

Coordinate care and manage referrals to other physicians

Share data electronically with other providers

Patient Panel Size 1


% of Panel on Medicare 1
Medicare Patients
% of Medicare patients CCM Eligible 2
% of CCM Eligible Patients
Annual Billing for CCM Patient
Annual CCM Revenue Potential

1)  Per the MGMA Cost Survey for Single Specialty Practices: 2013 Report Based on 2012 Data specific to the specialty of family medicine.
Includes Medicare A/B and Medicare Advantage

2) – County Level Multiple Chronic Conditions (MCC) Table: 2012 Prevalence, National Average

* Reimbursement amount from the CY 2015 Physician Fee Service Final Rule; assumes 100% of unique patients are covered by Medicare A/B. Medicare Advantage reimbursement may vary