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Billing Codes

You must provide 1 face-to-face visit within the timeframes described by these 2 CPT codes:

  • 99495 —Transitional Care Management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge; Medical decision making of at least moderate complexity during the service period; Face-to-face visit, within 14 calendar days of discharge
  • 99496 —Transitional Care Management services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge; Medical decision making of high complexityduring the service period; Face-to-face visit, within 7 calendar days of discharge

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