What is the CPT code for transitional care management?

The two CPT codes used to report TCM services are: CPT code 99495 – moderate medical complexity requiring a face-to-face visit within 14 days of discharge. CPT code 99496 – high medical complexity requiring a face-to-face visit within seven days of discharge.

Can you bill a TCM code with an E&M?

A7: Yes, for an E/M visit you can bill additional visits other than the one bundled E/M visit in the TCM.

What is TCM coding?

Codes 99495 and 99496 are used to report transitional care management services. (TCM). These services are for an established patient whose medical and/or. psychosocial problems require moderate or high complexity medical decision making.

Who can bill TCM codes?

Nonphysician providers such as physician assistants and nurse practitioners may also bill these codes following the incident-to coding rules. A key point to remember is that only one provider, per patient and per discharge, may bill a TCM code during the 30 days following discharge.

What is the CPT code for transition of care?

The Current Procedural Terminology (CPT) code 99495 as maintained by American Medical Association, is a medical procedural code under the range – Transitional Care Evaluation and Management Services.

When to Bill TCM codes?

TCM commences upon the date of discharge and continues for the next 29 calendar days. Only one individual (provider) may bill the TCM code and only once per patient within 30 calendar days of discharge.

What is transition care management?

Transitional Care Management (TCM) are services provided to Medicare beneficiaries whose medical and/or psychosocial problems require moderate- or high-complexity medical decision making during transitions in care from a hospital or other health care facility to a community setting (e.g., home, rest home, assisted living).

What are TCM codes?

The two CPT codes used to report TCM are: 99495 – moderate medical complexity requiring a face-to-face visit within 14 days of discharge 99496 – high medical complexity requiring a face-to-face visit within seven days of discharge