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Transitional Care Management (TCM) Face-To-Face Vi ...
TCM Face-To-Face Documentation Requirements
TCM Face-To-Face Documentation Requirements
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Pdf Summary
This document serves as a reference for home-based primary care providers and practice staff regarding the face-to-face documentation requirements for Transitional Care Management (TCM) visits. The resource provides information on the specific Evaluation and Management (E/M) codes that should be reported for TCM visits based on the complexity of the medical decision making. It also outlines the time frame and interactive contact requirements for these visits.<br /><br />In addition to the face-to-face visit, CMS expects certain services to be rendered as part of TCM, including obtaining and reviewing discharge information, medication reconciliation, follow-up on pending orders, communication with other healthcare professionals, patient education, and referrals to community resources. However, concurrent billing for TCM services is not allowed during the same service period as certain other services, such as medical team conferences, education and training, telephone services, and online medical evaluation services.<br /><br />The document also provides guidance on the types of medical decision making and the associated diagnoses, management options, data amount and complexity, and morbidity and mortality risk.<br /><br />For billing purposes, only one physician or non-physician practitioner may report TCM services, and these services can only be reported once per patient during the TCM period. The same healthcare professional may discharge the patient from the hospital, report discharge services, and bill TCM services, but the required face-to-face visit cannot occur on the same day as discharge day management services are reported.<br /><br />The document concludes by directing readers to additional resources, including the HCCIntelligence Resource Center, which offers webinars, tools, and tip sheets on home-based primary care topics, and the CMS Transitional Care Management Service MLN Booklet for more detailed information on TCM practice, guidelines, and billing.
Keywords
home-based primary care providers
Transitional Care Management (TCM) visits
Evaluation and Management (E/M) codes
medical decision making
discharge information
medication reconciliation
follow-up on pending orders
patient education
referrals to community resources
concurrent billing
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