Transitional Care Management Documentation Template

Support for michigan care management resource center is provided by blue cross and blue shield of michigan as part of the bcbsm value partnerships program. It is expected that the non face to face services listed will be routinely provided as part of transitional care. 99495 99495 communications with patientfamilycaregiver within 2 business days post discharge telephone direct electronic o monday through friday holidays dont count if not successful at reaching two attempts required medication reconciliation and management prior to.

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Jameslhollymd Com Epm Tools Transitions Of Care

A template to help physicians record details of the face to face visit portion of a transitional care service.

Transitional care management documentation template. Healthcare providers retain responsibility to submit complete and accurate documentation. The transitional care management codes require one face to face visit certain non face to face services as described in the article and medication reconciliation and management during the 30 day. You must furnish the required face to face visit under minimum direct supervision subject to applicable state law scope of practice and the medicare physician fee schedule pfs incident to rules and regulations. Face to face transitional care visit documentation.

To ensure all required documentation to support tcm services is completed and so that none of these 4 pages get lost reproduce this form on the front and back of 11x17 paper and fold it in half to 8 12 x 11 booklet size. Transitional care management services mln fact sheet page 3 of 8. Reprints must include this footer tcm documentation and flow sheet. Acp also has published several articles detailing the scope and appropriate use of the tcm.

The cpt codebook provides codes and guidelines to report tcm which allows providers to recoup payment for services they may already provide to their patients. Transitional care management tcm. It is not intended to replace published guidelines. This checklist is intended to provide healthcare providers with a reference to use when responding to medical documentation requests for transitional care management tcm services.

Sample tcm documentation and flow sheet cms offers guidance on how to use the new transitional care management codes tcm 99495 and 99496 in the medicare part b program. Transitional care management tcm describes the oversight and coordination of healthcare services for patients transitioning from an inpatient hospital setting. Transitional care management documentation checklist use to verify document ation supports the use of these new codes this checklist is not maintained as part of the medical record.