Reimbursement: Report TCM Codes Correctly To Keep Income Flowing

Why This Topic Matters

Transitional care management claims are time-sensitive and payer-specific, so understanding the differences discussed here can help reduce denials, support compliant reporting, and protect revenue.

Article Sections

1. CPT 2013 transitional care management codes

   Introduces the TCM codes added in CPT 2013 and summarizes the broad service elements tied to those codes.

2. CMS advice and differences from CPT

   Summarizes CMS guidance from a Rural Health Open Door Forum call and outlines the main ways Medicare reporting expectations differ from CPT guidance.

3. Patient type, visit timing, and communication timing

   Discusses differences related to patient status, the timing of face-to-face services, and the timing of initial contact attempts after discharge.

4. Other billable services during the TCM period

   Addresses how additional services by other practitioners may be handled during the 30-day TCM period and references related Medicare-covered service reporting considerations.

5. Final note on Medicare payment timing

   Explains the article’s closing note about how Medicare handles payment for TCM claims and when reimbursement begins after discharge.