The information provided here applies to Medicare coding. Be sure to check with your Medicare Administrative Contractor (MAC) for additional information and clarification on these and other items. You should also contact your local insurance carriers to determine if private insurers follow Medicare's lead on all coding matters.
Additional Transitional Care Services Material Released
Effective January 1, 2013, Medicare pays for two Current Procedural Terminology (CPT) codes (99495 and 99496) that are used to report physician or qualifying nonphysician practioner care management services for a patient following discharge from a hospital, skilled nursing facility or community health center stay, outpatient observation or partial hospitalization. In an effort to clarify some questions that have arisen around the 30-day transitional care management period and to promote proper coding, the Centers for Medicare and Medicaid Services (CMS) released a Medical Learning Network document entitled, “Transitional Care Management Services.” The document is available at www.cms.gov/Outreach-and-Education/....pdf.