To increase the quality of patient care and reduce hospital re-admissions.

CPT Code 99495 – TCM services with moderate medical decision complexity (face-to-face visit within 14 days of discharge)
CPT Code 99496 – TCM with high medical decision complexity (face-to-face visit within 7 days of discharge)

The 30-day TCM period begins on the date the beneficiary is discharged from the inpatient hospital setting and continues for the next 29 days.

What date of service should be used on the claim?
The date of service you report should be the date of the required face-to-face visit. You may submit the claim once the face-to-face visit is furnished and need not hold the claim until the end of the service period.

What place of service should be used on the claim?
The place of service reported on the claim should correspond to the place of service of the required
face-to-face visit.

Can E/M be reported together with TCM?
Reasonable and necessary evaluation and management (E/M) services (other than the required face-to-face visit) to manage the beneficiary’s clinical issues separately can be reported together with TCM

CMS Transitional Care Management

FAQ about Billing the Medicare Physician Fee Schedule for TCM Services