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.
CMS Posts Information Regarding Billing for Transitional Care Management Services
The Centers for Medicare and Medicaid Services (CMS) has posted Frequently Asked Questions about billing Medicare for Transitional Care Management services on its Physician Fee Schedule web page. 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. Additional information is available at www.cms.gov/Medicare/Medicare...pdf.