CPT^® 99495, Under Transitional Care Management Services

The Current Procedural Terminology (CPT^®) code 99495 as maintained by American Medical Association, is a medical procedural code under the range - Transitional Care Management Services.

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Summary

The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making, contact within two business days, and a face–to–face visit within 14 days of discharge.

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Transitional Care Management (99495 and 99496) with a Medicare Wellness

[QUOTE="ivygirl18@hotmail.com, post: 516199, member: 239460"] Due to nothing saying you can or can't bill these two together, do you interpret that as it being allowed? [/QUOTE] According to CCI data,... [ Read More ]

Transitional Care Management (99495 and 99496) with a Medicare Wellness

[QUOTE="TThivierge, post: 516062, member: 216725"] Hi Ivy Girl :) In medical office use to work in we did bill both CPT 99495 or CPT 99496 and annual wellness same date. Adding modifier 25 on annual w... [ Read More ]

Transitional Care Management (99495 and 99496) with a Medicare Wellness

Hi Ivy Girl :) In medical office use to work in we did bill both CPT 99495 or CPT 99496 and annual wellness same date. Adding modifier 25 on annual wellness CPT. However documentation had to be such ... [ Read More ]

Transitional Care Management (99495 and 99496) with a Medicare Wellness

Hi everyone, Can you bill Transitional Care Management (99495 and 99496) with a Medicare Wellness on the same day? I have checked on my MACs website and NCCI edits, but found nothing. I have a provid... [ Read More ]

TCM and Home Visit

Good afternoon, Hope everyone is having a fantastic Monday! Is it possible to bill TCM 99495 and 99350 on the same day without a modifier? Thank you for your help!... [ Read More ]

TCM and Home visit

Good afternoon, Hope everyone is having a fantastic Monday! Is it possible to bill TCM 99495 and 99350 on the same day without a modifier? Thank you for your help!?... [ Read More ]

Transition of Care

[QUOTE="houmaob1714, post: 508632, member: 242091"] If a patient is seen within 7 days of discharge and the documentation only meets moderate complexity, is it appropriate to bill 99495? [/QUOTE] I ag... [ Read More ]

Transition of Care

Modifier 25 with 99223 and 99497

Based on NCCI guidelines, modifier 25 would be appended to CPT 99497 when reported with 99223 when appropriate. For this NCCI edit pair, CPT 99223 is the column 1 code and 99497 is the column 2 code.... [ Read More ]

Billing 99495

Hi! I code for the CPT often, and we sometimes get kickback on it. In order for the Transition of Care codes to be accepted, the following must be met. [LIST=1] [*]Patient must be admitted, not an E... [ Read More ]

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