An Overview of TCM Services and CPT 99495 & 99496 This article provides details about billing for TCM services, and includes the comparative RVUs for TCM and established patient visits. Please note, RVUs listed are for 2018. CodingIntel updates RVU values annually. 99495: Transitional Care Management (TCM) Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or … [Read more...]
Wondering about Transitional Care Management?
A Video Overview of TCM Codes Finally, payment for services practices typically do for free! Transitional Care Management (TCM) provides payment to medical practices for helping complex patients transition from a facility to a non-facility setting, for example, from the hospital to home. It pays for the provider and clinical staff to perform non-face-to-face services and get paid for the work. Watch this 15 minute video courtesy of CodingIntel … [Read more...]
Can’t I Bill TCM for all Discharged Patients? Rules and Comments
An Overview of Transitional Care Management for Discharge “I can bill all discharges with Transitional Care Management codes. They’re all moderate complexity” Recently, a client wrote to me about a physician who wants to use the Transitional Care Management (TCM) codes for all discharges. The physician stated that all patients who were discharged from the hospital had at least moderate complexity on the day of discharge and so should be … [Read more...]
Performing services that increase primary care revenue
CMS states it wants to increase pay to primary care physicians. And while we might quarrel with their strategies or with the speed of achieving the goal, few would quarrel with the goal itself. In recent years, CMS has developed HCPCS codes and adopted CPT codes, some limited to primary care and some not specialty restricted but all likely to be reported by primary care practices. Meanwhile, although payment systems are moving to outcome and … [Read more...]
Transitional Care Management (TCM) update
Here's the latest on Transitional Care Management Services: Date of service: use 29th day following discharge or counting day of discharge as day one, day 30. Place of service: use place where mandated, bundled face-to-face E/M occurred. What does licensed clinical staff mean? No clarification yet from CMS. FAQ being developed by them. All staff must practice within their state scope of practice. If patient is re-admitted during 30 … [Read more...]