Transitional Care Management Services: Helping Patients Navigate Healthcare Changes
What are TCM Services?
TCM services help support patient care during transitions between care settings such as from the hospital to home or from the doctor's office to a new care facility. TCM services provide important coordination of care for patients to help prevent medical errors and readmissions.
The Role of Transitional Care Management in Healthcare
Transitional care management plays an important role in helping patients successfully transition between different care settings. When patients are discharged from the hospital or experience a change in their care needs, ensuring continuity of care is critical. Through TCM services, important information is communicated between providers to support coordination of all aspects of follow-up care. This helps minimize gaps and reduces the chance of errors or overlooked needs. Coordinated transitional care is also important for improving patient outcomes and satisfaction.
Billing and Payment for Transitional Care Management Services
Transitional Care Management Services services utilize specific billing codes to allow for reimbursement by Medicare and other insurance providers. There are two primary billing codes used - 99495 and 99496. Code 99495 is for moderate medical decision complexity during a transition in care, such as when a patient has two or more chronic illnesses. Code 99496 is for high medical decision complexity, such as when a patient has multiple chronic illnesses with acute exacerbation, undiagnosed new problem, or other significant event.
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