On January 1, CMS began paying primary care physicians a monthly fee to coordinate care for Medicare beneficiaries with multiple chronic conditions, even if there is no face-to-face exam. The policy was finalized in the CY 2014 Medicare Physician Fee Schedule Final Rule, to take effect in 2015. This is a significant policy shift from Medicare’s historical position, which is that it pays a fee for services provided to a beneficiary in a doctor’s office or hospital. Currently, about two-thirds of Medicare beneficiaries have multiple chronic conditions, such as diabetes and high cholesterol, but their care oftentimes is fragmented, and they end up seeing a different specialist for each condition. To earn the monthly fee, which is about $40 per patient, a physician must develop a plan of care for a qualified patient and spend time each month on activities such as coordinating care with the beneficiary’s other healthcare providers, monitoring medicines, and taking after-hour calls. A patient must agree to care coordination, because the fee is subject to Medicare’s standard deductible and co-insurance. The care coordination fee is one of CMS’s efforts to help practitioners better manage their patient’s conditions, and the agency is considering expanding the program so that it is available to all Medicare beneficiaries, not just those who already have multiple chronic conditions.