Wiki 99495 & 99496

[MLVaughan0986]

Hello,

Has anyone used these codes, 99495 and 99496? Does anyone know the criteria that needs to be met in using these codes? Does the caregiver have to be the pcp or could it be the specialist? In order to bill these codes what conditions have to be satisfied to bill them? I appreciate any help regarding this.

Thank you,

Maggie

 

[jhendrix08]

Here is a link from CMS that has great information for billing the Transitional Care Management codes. Hope it helps! We haven't had any trouble with reimbursement.

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

 

[ltskiver@gmail.com]

TCM billing

Does anyone know which insurances DO NOT accept TCM codes?

 

[cwrigh1@gmail.com]

Is TCM only for Medicare patients? I am getting conflicting information about commercial ins.

 

[byuangel26]

I have had denials for Medicaid and Medicare People's Health for TCM. All other private insurance and Medicare pay.