Home Forums Discussions Coding and Billing Medicare Transition of Care Codes

Is anyone using the new (2013) Medicare TCM codes? I just read another article about how it will 'revolutionize' primary care. However, I have not used the codes and I talked with my billing service and they do not report anyone using them. For instance, 99495 is used for coordination and a visit after discharge from a hospital.

Just started using them 2 weeks ago, haven't yet heard from my biller if they are getting paid or not. When I hear will repost.

I appreciate you posting that. I was surprised as this biller serves about a dozen different practices here, and no one is using the codes yet.

Our office has been using them.
Have to set up a routine for identifying recent discharges, then set up appointments within Medicare time frame.
Office manager says we get paid, and it is better than other codes. I haven't personally checked.

Our office used these codes initially but we don't use them any longer. The TCM payment covers all physician services provided for 30 days. Although Medicare "supposedly" will cover other uniquely different E/M services during this period, they have to be distinctly different than the reason for the TCM code, and in fact are usually disallowed. In our practice, we usually see post discharge patients more than once in the 30 days after discharge, and the payment for 1 TCM is less than these visits. I'm sure the Medicare bean-counters realize this. YMMV.

I'm not aware that has been a problem for us -- but now that you bring it up, I'll have to look into it.
Paying offices for "bundled" services and "quality metrics" is going to favor the payor -- unless we figure out how to game the system, I suppose.
Everyone else does.