AHA Coding Clinic® for HCPCS - 2012 Issue 4; For your Information

Transitional Care Management

As part of a multi-year strategy exploring the best means to encourage the provision of primary care and care coordination services to Medicare beneficiaries, CMS is adopting the following CPT transitional care management codes in place of the initially proposed HCPCS G-code: CPT code 99495 (Transitional care management services w/moderate medical decision complexity; Face-to-face visit within 14 days) and CPT code 99496 (Transitional care management services w/high medical decision complexity; Face-to-face visit within 7 days). CPT code 99495 includes the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge...

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