03.04J Complex Care Plan

Physicians claiming the 03.04J Complex Care Plan must be the patient’s regular physician of record and must intend to continue to provide ongoing comprehensive care of the patient for their conditions outlined in the comprehensive care plan.

Be sure to explain to the patient that you are completing a care plan for them and that you intend to provide ongoing care for their conditions. Prior to starting the care plan, physicians are encouraged to ask their patients if they are aware of any other physician that has completed a care plan for them in the last year.

Please note: As of April 1, 2014, 03.04J now includes a re-evaluation and revision of the plan within a year but no less than 345 days.

Updated Complex Care Plan Template >>
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