# 99496 along with 99214



## swhager

Can you bill a 99496 at the same time as 99214? I say no and my boss says yes.


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## SDAlward

No you can't.  You can't bill an office visit charge the same month as a TCM


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## Cynthia Hughes

*TCM includes one face-to-face visit*



swhager said:


> Can you bill a 99496 at the same time as 99214? I say no and my boss says yes.



Not if the 99214 visit is the one visit included in TCM. CPT states, " The first face-to-face visit is part of the TCM service and not reported separately. Additional E/M services provided on subsequent dates after the first face-to-face visit may be reported separately. "


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## Amanda8899

I am confused.. so if we see a patient for TCM visit  within the 7 - 14 days and they need to be seen again within the 30 days for a different problem can we charge a 99213?  And still bill the  99496 in 30 days?


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## OCD_coder

An E&M during the same face-to-face visit as the TCM performed may be improbable.  I've never seen it, but it would be difficult to separate the work for the TCM and separate E&M work.  However, a medically necessary encounter during the 30 day period is a billable service.

Here is what I found from CMS...


			https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Transitional-Care-Management-Services-Fact-Sheet-ICN908628.pdf
		

Report reasonable and necessary evaluation and management (E/M) services (except the required face-to-face visit) to manage the beneficiary’s clinical issues separately.

TCM FAQ


			https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Downloads/FAQ-TCMS.pdf
		

• *During the 30 day period of TCM, can other medically necessary billable services be reported? What about chronic care management services? 
*
Other reasonable and necessary Medicare services may be reported during the 30 day period, with the exception of those services that cannot be reported according to CPT guidance and Medicare HCPCS codes G0181 and G0182. CCM could be billed to the MPFS during the same calendar month as TCM only if the TCM service period ends before the end of a given calendar month, at least 20 minutes of qualifying CCM services are subsequently provided during that month, and all other CCM billing requirements are met. However we expect that the majority of the time, CCM and TCM will not be billed during the same calendar month.https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Transitional-Care-Management-Services-Fact-Sheet-ICN908628.pdf


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