Transitional Care Management: Finally Get Paid What You Deserve

Length: 60 minutes Expert: Michael Stearns, MD, CPC, CFPC, CRC CEU: 1.0

If your practice sees patients post discharge, you are most likely losing money. CMS estimates that practices that implement Transitional Care Management (TCM) services will see a 2% or more increase in overall revenue. In fact, you can double your Medicare reimbursement for TCM services, if you know how….

Simply put, TCM codes 99495 and 99496 allow your practice to be paid for services you’re already providing to help your patients successfully transition post-discharge — services you currently offer for FREE. Utilizing TCM codes correctly can be tricky. It requires attention to detail and a thorough understanding of their compliance requirements. But, when you consider the possible increased reimbursement, it is well worth it.

This is where physician and certified professional coder, Michael Stearns, MD, CPC, CFPC can help. During a 60-minute online training, Dr. Stearns will provide you with step-by-step instructions on how to accurately utilize and comply with these complex codes. After this training, you’ll be able to start submitting claims for TCM immediately – and getting paid more for them, too.

Practices in your area saw a significant boost in Medicare reimbursements last year by accurately using TCM codes 99495 and 99496. Here are just a few of the questions you’ll get answered during this must-attend, 60-minute practical session:

  • How does service location fit into the equation?
  • Do patients have to be a certain age to qualify?
  • Can you only use codes 99495 and 99496 for established patients?
  • What diagnoses should be used?
  • What type of providers can take advantage of these codes (MDs, PA, etc.)?
  • What if you can’t reach the patient or caregivers during the two days post-discharge?
  • How are calendar days and business days used when providing TCM services?
  • What if the patient isn’t present for the face-to-face meeting, the caregiver shows up instead?
  • When does the medication reconciliation take place, and does it have to be during a face-to-face encounter?
  • Can you still bill for TCM if you miss a post-discharge window based on business or calendar days?
  • Are TCM services limited to the discharging provider?
  • What can be coded and billed in addition to the TCM services during the TCM time period?
  • Can you bill TCM if the patient is admitted again within the 30-day TCM period for the initial discharge?
  • How is medical decision-making used when determining TCM level of service?
  • What should the date of service be on the TCM services claim?
  • How many times can you use the TCM codes for one patient?
  • How do TCM codes compare to the Chronic Care Management codes?
  • And many more…

Who should attend? Don’t make the mistake of thinking that using TCM codes is not worth it. This training session will help clinicians, office managers, auditors, and coding professionals better understand these confusing codes. It will help you more accurately utilize them and boost your TCM reimbursement.

You deserve to be paid accurately for post-discharge services. They are an important part of ensuring your patients are well cared for and stay out of the hospital long-term. Learn how to seamlessly implement (or better utilize) TCM codes 99495 and 99496 into your practice to and finally get paid more of what you deserve. Don’t delay, register for this must-attend online training today.

Meet Your Expert

Michael Stearns
MD, CPC, CFPC, CRCPhysician Informaticist

Michael Stearns, MD, CPC, CFPC, CRC is a physician informaticist, certified professional coder (CPC), certified family practice coder (CFPC) and certified risk adjustment coder (CRC). He is the CEO and Founder of Apollo HIT, LLC, an organization that provides healthcare information technology (HIT) and compliance consulting services.

His company assists organizations with meeting their documentation, compliance, coding, risk adjustment, EHR optimization and other program goals; including performance in quality and efficiency-based incentive programs.


I loved it! There was a lot of great information.
Diana Sickles