Billing Medicare for Transitional Care Management Services — What You Need to Know

 Based on the 2013 Physician Fee Schedule final rule, which took effect January 1, 2013, Medicare pays for two CPT codes (99495 and 99496) that are used to report physician or qualifying non-physician practitioner care management services for a patient following a discharge from a hospital, skilled nursing facility or a community mental health clinic stay, outpatient observation or partial hospitalization.

Both the Centers for Medicare and Medicaid Services (CMS) and the North Carolina Medical Society (NCMS) Member Resource Coordinator have fielded questions about this reimbursement. Click here for a list of FAQs you may find helpful on this matter. 



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