Get AAFP Transitional Care Management 30-Day Worksheet 2013-2024

The TCM claim may be submitted on the date of the face-to-face visit. 6 TCM codes may only be paid once within a 30-day time frame. That means that only one provider can bill for the service, and if the patient is readmitted, a second TCM code may not be submitted within the same 30-day time frame.

Procedure Codes for Transitional Care Management CPT Code 99495 covers communication with the patient or caregiver within two business days of discharge. This can be done by phone, e-mail, or in person. ... CPT Code 99496 covers communication with the patient or caregiver within two business days of discharge.

The codes must be billed using the seventh or 14th day as the date of service and only one healthcare professional may report this service. If more than one physician assumes care and a claim is denied, the provider can bill the visit using an code. The TCM service may be reported once during the entire 30-day period.

Transitional care management (TCM) is intended to reduce potentially preventable readmissions and medical errors during the 30 days following discharge from the acute care setting. The TCM codes recognize the additional work required to provide support to patients after discharge.

To support a TCM service, documentation must contain, at a minimum, the date the patient was discharged from acute care, the date the provider contacted the patient (two days post-discharge), the date the provider saw the patient face-to-face (either seven or 14 days), and the complexity of the MDM (moderate or high).

At a minimum, documentation for TCM must include: Date the beneficiary was discharged. Date of the interactive contact with the beneficiary and/or caregiver. Date of the face-to-face visit. The complexity of medical decision making (moderate or high)

99495 Transitional Care Management Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge. Medical decision making of at least moderate complexity during the service period.

To support a TCM service, documentation must contain, at a minimum, the date the patient was discharged from acute care, the date the provider contacted the patient (two days post-discharge), the date the provider saw the patient face-to-face (either seven or 14 days), and the complexity of the MDM (moderate or high).