AMA CPT® Assistant - 2013 Issue 4 (April)
Transitional Care Management Services (April 2013)
April 2013 pages 3-4 Transitional Care Management Services In order to address the need for coordination of care, the Evaluation and Management (E/M) section in the 2013 CPT codebook was revised to include two new subsections: Complex Chronic Care Coordination Services and Transitional Care Management Services. This article focuses on the new Transitional Care Management Services subsection. Transitional care management (TCM) services are performed during transitions in care from an inpatient hospital setting (including acute hospital, rehabilitation hospital, long-term acute care hospital), partial hospital, observation status in a hospital, or skilled nursing facility/nursing facility, to the patient's community setting...
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Article Overview
This article explains the CPT transitional care management framework introduced in 2013 and summarizes the scope of post-discharge care coordination services covered in the CPT Evaluation and Management section. It is relevant to coders, billers, compliance staff, and clinicians who document and report transitional care services across inpatient, facility, and community settings. The article also highlights timing requirements, required service elements, and related E/M services and code families referenced in the guidance.
Why This Topic Matters
Transitional care management reporting depends on specific service timing, documentation, and code selection criteria. Understanding the article helps readers distinguish TCM from other E/M and care coordination services and recognize the broader coding context in which it sits.
Article Sections
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Transitional Care Management Services
Introduces the CPT transitional care management subsection and describes the general service setting, patient population, and care coordination framework. It also summarizes the major components of reporting and documentation covered in the article.
What You Will Learn
- The general scope of transitional care management services in CPT
- The settings and patient transitions addressed by the article
- The major timing and documentation topics associated with TCM reporting
- How TCM is positioned among related E/M and care coordination services
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physicians and other qualified health care professionals
- Clinical documentation specialists
Codes Discussed
Code Ranges Discussed
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