AMA CPT® Assistant - 2014 Issue 3 (March)

Evaluation and Management: Transitional Care Management Services [(Q&A)] (March 2014)

March 2014 page 13 Evaluation and Management: Transitional Care Management Services Question: If multiple physicians are involved with the patient's care and the patient is being transferred to an extended care facility, can multiple physicians report codes 99495 and 99496? Answer: No. As stated in the Transitional Care Management (TCM) guidelines in the CPT® 2014 code set, "Only one individual may report these services and only once per patient within 30 days of discharge. Another TCM may not be reported by the same individual or group for any subsequent discharge(s) within the 30 days. The same individual may report...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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