# Billing Transtion of care to BCBS



## rzapp49@yahoo.com (Aug 24, 2016)

Can any one tell me why BCBS is denying transition of care codes ( 99495 -99496 ) . I have been getting paid from other insurance , I cant get BCBS to pay these codes. Can any one help with this. Thank you


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## Rebecca Pate (Oct 28, 2016)

*Bcbs tcm*

I am having the same problem.  The explanation they give makes no sense.  Does anyone have any insight to offer?

Thanks!


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## abyrne (Nov 10, 2016)

Anthem BCBS does not cover TCM codes.
These most likely will need to be billed out as EM codes if appropriate.


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## amybalcomhall@gmail.com (Nov 10, 2016)

TOC is a non-covered service under BCBS.  We went through this a year ago & had the same confusion because they had Cpt codes 99495 & 99496 on their fee schedule. 
We received clarification from our Provider Rep & TOC is definitely non-covered.  You will have to bill these visits following E/M coding guidelines.

Perhaps they will cover TOC in 2017.  I know under best practices thre are only a handful of codes that will be payable in 2017 and the rest will fall under capitation. We'll have to wait and see.


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