# Case manager billing?



## dflieger (Nov 8, 2012)

anyone out there do any services performed by nurse case managers?


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## Pam Brooks (Nov 8, 2012)

There are new codes in 2013 for Transitional Care managment and Complex Chronic Care Management (99495-99496 and 99487-99489 respectively)  that can be done by RNs, incident-to the provider. 

We're working on developing EHR templates to capture the documentation requirements, and in the meantime, we'll use a paper form.  There are patient criteria and face-to-face criteria that need to be met, which are outlined in CPT.  

There is also a G code soon to be released from CMS for the TCM service w/o face-to-face with a physician.  Since the fee schedule and HCPCS aren't yet available, I don't have fees or work RVUs to provide, although it's been proposed that the code will hold about the same value as a 99213.  Not sure about coverage guidelines, either.  I wish CMS would have their stuff together way before January, but I guess that's too much to hope for. 

Hope this helps.


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