ARE YOU COMPLIANT WHEN PROVIDING TRANSITIONAL CARE MANAGEMENT SERVICES?

| Posted on |

May 3, 2023

Transitional care management (TCM) services are intended to help a patient transition, upon discharge, from an inpatient setting back to their home setting.  Here are several areas you will want to look into for proper coding, documentation, and billing guideline use:

  • Who are the eligible providers that can perform TCM services?
  • Who can perform the non-face-to-face vs. face-to-face portion of the TCM service?
  • What types of locations are approved for post-discharge TCM services?
  • What elements qualify for a TCM visit?
  • When do “incident-to”/supervision rules and scope of practice/state laws apply?
  • Can other services be provided during the TCM period?
  • Have you met the following requirements:
    • Billing, coding, and documentation
    • Medical decision making
    • Medication reconciliation and management
  • How can telehealth be used for TCM services?  (Consider during Public Health Emergency (PHE) and post-PHE requirements.)

The Honest Approach helps in evaluating TCM services. If you have questions, we have answers, so please email us if we can be of assistance.

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