decisionhealth Newsletters, Part B News - 2022 Issue 3 (March)
Transitional care management hit a COVID wall, but denials dropped too
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Article Overview
This premium article examines Medicare transitional care management activity during the pandemic, with attention to utilization trends, claim acceptance rates, and where denials were most and least common. It is aimed at coders, billers, compliance staff, and clinicians who work with transitional care services and want to understand how 2020 claims patterns differed from prior years. The discussion also places the service in the context of COVID-era telehealth flexibilities and specialty-level billing patterns.
Why This Topic Matters
TCM is a commonly billed Medicare service, and pandemic-era changes affected both volume and payer review outcomes. Understanding overall trends, specialty patterns, and setting-related denial differences can help organizations monitor performance and compare their own claims experience against broader Medicare data.
What You Will Learn
- How transitional care management utilization changed during the pandemic period
- How Medicare claim denial rates for transitional care management shifted in 2020
- Which specialties accounted for most transitional care management billing
- How place of service affected claim acceptance patterns for transitional care management
- How COVID-era telehealth flexibility related to transitional care management service delivery
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Compliance professionals
- Physicians and advanced practice clinicians
- Practice managers
Codes Discussed
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