# TCM with AWV?



## stephsaylor30@yahoo.com (Oct 17, 2016)

Does anyone know if you can report 99495 (transitional care management) and G0439 (Medicare annual wellness visit) on the same date of service with 25 modifier on 99495?  A patient was seen in the office today for hospital f/up.  All components of the tcm have been met thus far (post dc f/up non face to face contact, face to face visit with moderate mdm).  While the patient was here the provider also administered the Medicare annual wellness visit.  If the patient stays out of the hospital for the thirty day tcm period, can I report both the tcm and AWV on the same dos?    I've not found any other threads about reporting these two codes together. 

My issue is the CPT book states that "the reporting individual provides or oversees the management and/or coordination of services, as needed, for all medical conditions, psychosocial needs and activity of daily living support by providing first contact and continuous access."  This sort of piggybacks on the components of the HRA for an annual wellness exam (psychosocial risks, and ADLs).  It's my understanding that it's not appropriate to "double dip".  Any advice/guidance would be greatly appreciated!!!

Stephanie Saylor, CPC


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## thowell6733 (Jan 21, 2020)

I would also like to know the answer to the above question. Does anyone know if you can report 99495 (transitional care management) and G0439 (Medicare annual wellness visit) on the same date of service with 25 modifier on 99495? A patient was seen in the office today for hospital f/up. All components of the tcm have been met thus far (post dc f/up non face to face contact, face to face visit with moderate mdm). While the patient was here the provider also administered the Medicare annual wellness visit. If the patient stays out of the hospital for the thirty day tcm period, can I report both the tcm and AWV on the same dos? I've not found any other threads about reporting these two codes together. My issue is the CPT book states that "the reporting individual provides or oversees the management and/or coordination of services, as needed, for all medical conditions, psychosocial needs and activity of daily living support by providing first contact and continuous access." This sort of piggybacks on the components of the HRA for an annual wellness exam (psychosocial risks, and ADLs). It's my understanding that it's not appropriate to "double dip". Any advice/guidance would be greatly appreciated!!! Terri Howell, COC, CDEO


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## 1christinepeters (Oct 23, 2020)

stephsaylor30@yahoo.com said:


> Does anyone know if you can report 99495 (transitional care management) and G0439 (Medicare annual wellness visit) on the same date of service with 25 modifier on 99495?  A patient was seen in the office today for hospital f/up.  All components of the tcm have been met thus far (post dc f/up non face to face contact, face to face visit with moderate mdm).  While the patient was here the provider also administered the Medicare annual wellness visit.  If the patient stays out of the hospital for the thirty day tcm period, can I report both the tcm and AWV on the same dos?    I've not found any other threads about reporting these two codes together.
> 
> My issue is the CPT book states that "the reporting individual provides or oversees the management and/or coordination of services, as needed, for all medical conditions, psychosocial needs and activity of daily living support by providing first contact and continuous access."  This sort of piggybacks on the components of the HRA for an annual wellness exam (psychosocial risks, and ADLs).  It's my understanding that it's not appropriate to "double dip".  Any advice/guidance would be greatly appreciated!!!
> 
> Stephanie Saylor, CPC




Modifier -25 is not allowed on 99495. 
Christine Peters, CPC


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