This article provides answers to frequently asked questions related to transitional care management services. It includes details about billing for … [Read more...]
Search Results for: transitional
Wondering About Transitional Care Management?
A Video Overview of TCM Codes Finally, payment for services practices typically do for free! Transitional Care Management (TCM) provides payment to … [Read more...]
Everyday Coding for Medical Practices
How can a practice protect its revenue? The easiest way is by collecting for services already performed, and the first step in that process is … [Read more...]
HCPCS Code G0136 for Assessment Social Determinants of Health (SDoH)
This is information from the 2024 Physician Fee Schedule Final Rule, released Nov. 2, 2023. New CPT and HCPCS codes, and CMS policy changes are … [Read more...]
What’s New in the Proposed Physician Fee Schedule Rule
Proposed Physician Fee Schedule Rule, 2024 CMS issued the Proposed Physician Fee Schedule (PFS) Rule July 13, 2023, with a 60-day comment period. … [Read more...]
Chronic Care Management
Medicare and private payers cover chronic care management services if a patient has two or more serious conditions that are expected to last at least … [Read more...]
Physician Fee Schedule Final Rule for Calendar Year 2023
2024 conversion factor $32.7442 (updated 1/3/2024) 2023 conversion factor $33.8872 (updated 1/5/2023) CMS continues to state it doesn't have … [Read more...]
When to Use Time to Select an E/M Service
Selecting a code for an E/M service can be done based on time or MDM (except ED visits which only use MDM) Time includes all time spent by the … [Read more...]
Can We Code TCM and 99214 Together?
Question: Can we code TCM and 99214 together? Answer: No, not if you mean on the same calendar date. On the day of the E/M service that is … [Read more...]
Care Management and Remote Monitoring
Technology advances and policy changes mean medical practices can now get paid for certain non-face-to-face services. But, you need to know how to … [Read more...]
Care Management Services | Webinar
TCM, PCM, CCM: care management services Recorded June 25, 2020 Physicians are frustrated when they do work, not related to seeing a patient, and … [Read more...]
What are the Requirements for Billing a TCM Visit?
Question: In order to bill a TCM visit, is anything else needed besides the phone call and E/M visit? (Codes 99495 and 99496) Answer: Yes, … [Read more...]
CMS 2020 Proposed Rule Updates
CMS rescinds bundled payments for 2021 and accepts CPT® revisions for new and established patients Proposes new HCPCS codes for care management … [Read more...]
Anticoagulation Management
Currently, there are two sets of codes, three HCPCS codes and two CPT® codes. They aren’t defined exactly the same, and so take careful reading. The … [Read more...]
Your Roadmap to Coding Care Management Services
The days when CMS and other payers only recognized face-to-face services with patients are behind us. There are multiple opportunities to bill for … [Read more...]
Remote Physiologic Monitoring Treatment Management Services
This is an overview of coding for Digitally Stored Data Services/Remote Physiologic Monitoring in the E/M section of the CPT book. There are more … [Read more...]
Are Start and Stop Times Required for Non Face-to-Face Prolonged Care Services?
Question: Regarding non face-to-face prolonged care, does Medicare require start and stop times, they way they do for prolonged face-to-face care? … [Read more...]
Wellness Visits and Care Management in Rural Health Centers and Federally Qualified Health Centers (RHCs and FQHCs)
RHCs and FQHCs are paid an all-inclusive rate (AIR) or national prospective payment system (PPS) rate for any service that is defined as a visit to … [Read more...]
New CPT® Codes for 2018 | Anticoagulation Management and Education for Home INR Monitoring
CPT developed (and Medicare recognizes) two new codes for services related to home and outpatient international normalized ratio (INR) monitoring … [Read more...]
Coding Guide – Care Management Services
CMS has a stated goal of recognizing management services provided outside of an office visit. In particular, valuing and paying for care management … [Read more...]
Getting Paid for Advance Care Planning
This 5 minute video covers the criteria for billing Advance Care Planning services, CPT® codes 99497 and 99498. For additional information on … [Read more...]