decisionhealth Newsletters, Part B News - 2021 Issue 4 (April)
Can your MA handle the TCM initial patient contact? Yes — until the patient responds
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Article Overview
This article reviews CMS guidance on transitional care management (TCM) and the roles different staff members may play in the initial post-discharge contact. It is aimed at medical coders, billers, and practice administrators who need to understand whether non-QHP staff can handle outreach, how CMS frames non-face-to-face TCM services, and what types of follow-up responsibilities remain with qualified professionals. The discussion is focused on operational workflow and compliance context rather than detailed clinical decision-making.
Why This Topic Matters
TCM services involve time-sensitive post-discharge communication, and practices need to know which staff may initiate outreach without compromising compliance. Understanding the distinction between staff participation and qualified health care professional responsibility helps organizations structure workflows appropriately.
What You Will Learn
- How CMS frames the initial contact portion of transitional care management
- How non-QHP staff participation fits into TCM workflows
- What general follow-up responsibility remains with qualified professionals
- How practices may think about outreach, case management, and patient communication in TCM
Who Should Read This
- Medical coders
- Medical billers
- Practice administrators
- Clinical operations staff
- Revenue cycle staff
Codes Discussed
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