Report codes 30 days after discharge, watch timing of face-to-face visit

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews transitional care management (TCM) billing under Medicare and CPT, with emphasis on timing, communication requirements, face-to-face visit windows, and related services that may not be reported separately. It is aimed at primary care and other practices that manage patients after discharge and need to understand the general framework for reporting TCM services. The article also notes how TCM interacts with other care coordination and communication code families.

Why This Topic Matters

Post-discharge billing depends on several timing and coordination requirements, so practices need to understand the general scope of TCM before deciding whether to adopt it and how it fits with other reporting options.

Article Sections

  1. Transitional care management

    Introduces the new transitional care management service category and the broader post-discharge context in which it is used.

  2. Timeframe

    Covers the reporting window for transitional care management and the general discharge-to-follow-up period discussed in the article.

  3. Communication

    Summarizes the communication component associated with transitional care management and the kinds of contact involved.

  4. Who can report

    Discusses which clinician groups are involved in reporting and the relationship between discharge-day services and follow-up reporting.

  5. Complexity and timing of the face-to-face visit

    Reviews how the article frames visit timing and complexity level as the main factors in selecting between the transitional care management services.

What You Will Learn

  • What transitional care management is in the post-discharge setting
  • What timing and communication elements are associated with transitional care reporting
  • How face-to-face visit timing relates to the broader TCM framework
  • What other service categories are discussed as not separately reportable with TCM

Who Should Read This

  • Primary care practices
  • Physicians
  • Qualified health care professionals
  • Clinical staff
  • Medical coders
  • Billing staff

Codes Discussed

Code Ranges Discussed


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