In this section, you’ll find:
• 360 Comprehensive Assessment benefits
• Codes for 360 Comprehensive Assessments and preventive care
• SHARE initiative for vaccinations
• Care coordination best practices
To learn more about what measures can be impacted by 360, click here.
The 360 Comprehensive Assessment is an important part of the Cigna Healthcare Medicare Advantage 2024 yearly health check-up benefit. It combines aspects of a physical wellness visit and preventive care to provide a complete picture of your patients’ health.
360 Comprehensive Assessment objectives
Provide accurate identification and documentation or preventive care opportunities.
Provide accurate documentation of current conditions and treatment plans.
Provide a full-circle picture of your patients’ health.
The 360 Comprehensive Assessment is an important tool that helps you provide quality care for Medicare Advantage patients – at no added cost to patients.
We encourage providers who are not utilizing Arcadia or Optum platforms to complete a Health Management Report (HMR) for their Cigna Healthcare Medicare Advantage patient during a face-to-face visit. The administrative payment will be sent to you once the submitted HMR and corresponding clinical notes are verified.
Receive additional funding beyond administrative reimbursement.
Codes to consider
The Medicare G codes may not be reported more than once a calendar year. Claims may be denied if the codes have been previously reported during the year. This may also apply to the preventive services codes.
Initial and periodical comprehensive preventive medicine CPT codes (99381–99397) can be reported for services performed during the completion of the 360 Comprehensive Assessment and Health Management Report. The comprehensive nature of these preventive services represents an age- and gender-appropriate history and examination. In addition, the services include counseling, guidance, and risk factor reduction interventions. Please refer to the AMA CPT manual for complete guidance on these codes.
The Medicare Annual Wellness Visit codes can be reported if a provider completes the 360 form during the course of the Medicare Wellness Visit. Additional information for the AWV requirements may be found at Medicare Wellness Visits (cms.gov)
These codes are provided as guidance only. Any code selection must be based on the services actually performed and documented in accordance with procedural coding guidelines.
These CPT II codes can be used to document your health conversations around the following topics related to CAHPS and HOS Star measures:
Your patients can track their preventive care with their Passport to Health. If your patients need a copy of the Passport to Health, they can contact Cigna Healthcare Customer Service at the phone number on the back of their ID card. Cigna Healthcare rewards patients for getting routine and preventive screenings, which provides additional motivation and can benefit your practice as well.
Your strong recommendation is a critical factor for your patients to get a flu vaccine.
Research indicates that most adults are likely to get a flu vaccine if their doctor or health care provider recommends it. Most adults believe vaccines are important, but need a reminder from you to get vaccinated.
If you do not offer vaccinations, make a referral. Then, follow up with each patient during subsequent appointments to ensure they received it.
Consider the SHARE initiative to guide flu vaccine conversations with your patients.
The Centers for Disease Control and Prevention (CDC) SHARE* initiative can help guide conversations with your patients.
62% of Star-rated CAHPS survey questions are geared toward patients’ experiences with your office (staff and providers).
For more information on how Stars are measured, visit CAHPS.
*For a downloadable educational flyer for your staff, go to (CDC.gov) > Health Topics A-Z > I > Influenza Vaccination > Health Professionals > Make a Strong Flu Vaccine Recommendation > Get the Toolkit > Make a Strong Influenza Vaccine Recommendation.
