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What Transitional Care Management Means and Why Your Patients Need It
Every health care provider knows how critical the first 30 days are after a patient has been discharged from in-patient care in a hospital or other medical facility. This is especially so if the patient suffered from a complex medical issue. Unless the patient has been provided…
February 25, 2021·rshah
Every health care provider knows how critical the first 30 days are after a patient has been discharged from in-patient care in a hospital or other medical facility. This is especially so if the patient suffered from a complex medical issue. Unless the patient has been provided with proper transition and high quality of care during this crucial time, there is a high probability of the patient getting readmitted.
Transitional Care Management (TCM) plays a big role in the full recovery of patients, whether they suffered from complications due to hypertension, diabetes, or others. But what really is TCM? Medistics Health provides you with the basic information on this important topic:
Transitional Care Management Defined
The Centers for Medicare and Medicaid Services or CMS initiated the Transitional Care management or TCM that aims to provide patients with the proper transition of care for the crucial 30 days after getting discharged from inpatient facilities, whether that’s an acute care hospital, a nursing home, a long-term care facility, a psychiatric facility, or a rehabilitation center. It is created so medical practitioners, including specialists and primary care physicians, nurses, nurse-midwives, and other authorized non-physician practitioners can provide the necessary care to patients needing them after confinement. This can significantly lessen the instances of readmission during this critical period by as much as 86%.How TCM Works
The TCM service starts on the day the patient is discharged and continues for 30 days. During this period these three components or services should be provided:- Interactive contact must be made in the next two days following the discharge of the patient. The contact may be made in-person or via phone and/or email. It may be done by the practice’s staff.
- Non-face-to-face services should be given by clinical staff members unless it’s determined that it is not medically necessary. The billing provider may provide instructions to their clinical staff to educate patients about self-management or to help them access health resources.
- A face-to-face visit may also be performed as directed by the CPT code. For CPT code 99495, a face-to-face visit must be performed within 2 weeks of discharge for patients with moderate medical complexity. For CPT code 99496, the visit should be done within a week of discharge for patients with high medical complexity.