Transitional Care Management (TCM) was developed by the Centers for Medicare & Medicaid Services (CMS) mainly for adults older than 65. However, the model presented through its requirements and the CPT codes that CMS reimburses is also accessible to clinicians serving patients under 65. Additionally, many commercial payors cover transitional care through various products and arrangements, which we will explore.

Care coordination includes organizing patient activities and services across multiple providers. The approach prioritizes communicating all relevant information to the participants involved in the person’s care. Its overall objective is to fulfill an individual’s care needs and preferences through high-quality, personalized engagement.

One of the powerful aspects of Medicare care management programs is that some are designed to work together. A primary example is offering Chronic Care Management (CCM) alongside Remote Patient Monitoring (RPM).

What is Transitional Care Management? Transitional Care Management (TCM) helps patients in the first 30 days following a hospital discharge. Covered by Medicare Part B, providers should learn what CPT billing codes are used for TCM in order to optimize care delivery and avoid denied claims.

The Centers for Medicare and Medicaid Services (CMS) has updated the 2025 Final Rule for Chronic Care Management (CCM). For 2025, there were no major changes to the CCM program rules and regulations in CMS’s Final Rule, but for the first time, Rural Health Clinics and Federally Qualified Health Centers can now bill the CCM CPT codes just like other fee-for-service practices. There are also updated reimbursement rates for the CPT codes.

This year brings significant opportunities and changes to care management that invite providers, health plans, and care management service organizations to transform. Central to these changes is the launch of the Advanced Primary Care Management program.

The Centers for Medicare and Medicaid Services (CMS) has introduced significant changes in the 2025 Physician Fee Schedule Final Rule, marking this as a crucial year for healthcare organizations. These changes are especially important for those already participating in Medicare care management programs or considering participating in them.

PITTSBURGH – ThoroughCare has announced that the company is entering a strategic partnership with CareCo, an innovative provider of generative AI-powered tools. This collaboration aims to assist care managers in streamlining patient, task, and call management, enabling them to dedicate more time to patient interactions and less to administrative work. CareCo’s advanced technology is designed to seamlessly integrate with ThoroughCare’s existing platform, facilitating a more efficient, AI-assisted workflow that minimizes manual entry, speeds up documentation processes, and reduces errors.

Providers implementing Annual Wellness Visits or quality improvement initiatives identify and hone best practices that meet their unique patient and practice needs. When operationalized, these standards achieve four goals:

The Centers for Medicare & Medicaid Services (CMS) released the Final Rule for its 2025 Medicare Physician Fee Schedule. It includes a significant change for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).