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Ineffective transitions of care challenge providers Readmission rates have remained high despite the Hospital Readmission Reduction Program (HRRP). The average US all-cause readmission rate is 14.56%, and it ranges from 11.2% to 22.3% across states. Other value-based care programs, where reimbursement is tied to the quality of service, haven’t led to a significant change in readmissions, either.
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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.
Transitional Care Management | CPT codes
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.
Chronic Care Management | Care Coordination | Remote Patient Monitoring (RPM) | Transitional Care Management | Behavioral Health Integration
Are you intimidated by offering multiple care management programs to your patients at a time? You don't have to be!
Transitional Care Management | Value-Based Care
Policy and value-based payment models promote the importance of managing transitions of care.
Transitional Care Management | Value-Based Care
A transition of care (ToC) involves moving a patient from one care site to another. These “moments of truth” are critical to ensuring continuity of care that is safe, efficient, and supports a successful healthcare journey.