By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    improving patient experience
    6 Ways to Improve Patient Satisfaction Within Hospitals
    December 1, 2021
    degree for healthcare job
    What Are The Health Benefits Of Having A Degree?
    March 9, 2022
    custom software development is changing healthcare
    Digital Customer Journey Mapping and its Importance for Healthcare
    July 21, 2022
    Latest News
    Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
    May 16, 2025
    Learn how to Renew your Medical Card in West Virginia
    May 16, 2025
    Choosing the Right Supplement Manufacturer for Your Brand
    May 1, 2025
    Engineering Temporary Hospitals for Extreme Weather
    April 24, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Can Thinking Younger Make You Live Longer?
    April 20, 2011
    Image
    Obesity’s Outlook Unchanged
    June 13, 2011
    When It’s An Emergency Elderly Not Treated As Well in Hospitals
    July 16, 2011
    Latest News
    Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
    May 18, 2025
    The Critical Role of Healthcare in Personal Injury Recovery: A Comprehensive Guide for Victims
    May 14, 2025
    The Backbone of Successful Trials: Clinical Data Management
    April 28, 2025
    Advancing Your Healthcare Career through Education and Specialization
    April 16, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Transitional Care Management: Reimbursement of Non-Face-To-Face Services
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Wellness > Home Health > Transitional Care Management: Reimbursement of Non-Face-To-Face Services
Home HealthPolicy & Law

Transitional Care Management: Reimbursement of Non-Face-To-Face Services

thielst
Last updated: March 5, 2013 9:30 am
thielst
Share
2 Min Read
Image
SHARE

Image

Image

As of January 1, 2013, the Medicare Physician Fee Schedule includes reimbursement for transitional care management (TCM) services from the hospital to the community setting.  The two relevant codes are 99495 and 99496 and apply to physicians and other qualified non-physician professionals.  The goal of this investment is to generate savings from a reduction in the number of re-admissions.

While this new approach to reimbursing for care is truly welcome, the inclusion of non-face-to-face care management services is an opportunity to leverage enterprise portals and social technologies to facilitate these processes.  The following services are required be provided unless they have been determined to not be medically necessary:

More Read

An In-Depth Overview Of The Healthcare LMS Market
Packing on the Pounds? Blame the Potato
Lab Results for All! Of Data Liberation, Participatory Medicine, and Government 2.0
Year-End Health Policy Musings
What Mental Health Parity Has Wrought

Performed by a qualified professional:  obtain and review discharge information; review need for, or follow-up on, pending diagnostic tests and treatments; interact with other providers involved in patient’s care; educate patient, family, guardian, and/or caregiver; arrange for needed community resources.

Performed by clinical staff or case manager under direction of qualified professional:   communicate with home health agencies and other community services utilized by patient; educate patient and/or family/caretaker regarding self-management, independent living, and activities of daily living; assess and support treatment regimen adherence and medication management; identify available community and health resources; facilitate access to necessary care and services.

Now is the time for innovative providers to develop new processes and create strategies for leveraging technologies to support delivery of these important and reimbursable services.

For a detailed summary of the billing requirements for TCM, visit the PYA Healthcare Blog and CMS FAQs.

TAGGED:transitional care
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Clinical Expertise
Building Smarter Care Teams: Aligning Roles, Structure, and Clinical Expertise
Health care
May 18, 2025
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
Health
May 15, 2025
Learn how to Renew your Medical Card in West Virginia
Learn how to Renew your Medical Card in West Virginia
Health
May 15, 2025
Dr. Klaus Rentrop Shares Acute Myocardial Infarction heart treatment
Dr. Klaus Rentrop Shares Acute Myocardial Infarction
Cardiology
May 13, 2025

You Might also Like

HHS
Policy & Law

HHS Issues Final Rule on State Health Insurance Exchanges

March 13, 2012
medicaid block grant
BusinessHealth ReformPolicy & LawPublic Health

A Medicaid Block Grant by Any Other Name Would Stink

March 24, 2015
lyme disease vaccine
Public Health

Lyme Disease Vaccine: Cautionary Tale or Opportunity for Renewed Activism?

October 4, 2013
NewsPublic HealthUncategorizedWellness

Top Tips To Prevent Lung Cancer And Keep Your Lungs Healthy

December 30, 2018
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?