decisionhealth Newsletters, Part B News - 2020 Issue 7 (July)
Robust TCM payment growth slows but still sees double-digit results
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Article Overview
This article examines how transitional care management has evolved in Medicare Part B over several years, focusing on payment and claims trends for the TCM service codes and the broader pattern of adoption over time. It is relevant to coders, billers, revenue cycle staff, and compliance professionals who monitor outpatient follow-up services, Medicare reimbursement trends, and annual updates tied to CMS payment policy.
Why This Topic Matters
Understanding long-term utilization and payment trends for transitional care management helps organizations evaluate Medicare revenue patterns and stay aware of payment updates affecting post-discharge care management services.
Article Sections
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TCM payment and claims growth trends
Overview of multi-year Medicare Part B payment and claims patterns for transitional care management services. The section describes how uptake changed over time and places the service in a broader reimbursement context.
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Year-by-year payment growth review
A chronological look at how payment growth changed across successive claim years. The section highlights the overall direction of the trend without providing coding guidance.
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Recent payment totals and CMS rate update
Discussion of the most recent available payment figures and the effect of a later CMS rate change. The section also summarizes the multi-year payment increase for the service category.
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Payments for TCM codes 99495 and 99496, 2013-2018
A data presentation section summarizing payment trends across the review period. It serves as a supporting reference for the article’s Medicare claims analysis.
What You Will Learn
- How transitional care management activity has changed over time in Medicare Part B
- What broad payment trend patterns are associated with the TCM service category
- Why later CMS payment updates are relevant to reimbursement monitoring
- How the article frames multi-year claims and payment analysis for outpatient follow-up services
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Compliance teams
- Practice managers
- Healthcare analysts
Codes Discussed
Code Ranges Discussed
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