The two codes — 99495 and 99496 — were created to pay physicians for the management of patients who have recently been discharged from a hospital or skilled nursing facility. The AMA CPT editorial panel created them with much input from the healthcare community.
The codes, categorized as transitional care management services, allow for efficient reporting of time spent discussing a care plan, connecting patients to community services, transitioning them from inpatient settings and preventing readmissions.
It’s been a year since the AMA called on CMS to adopt the new codes and cover the related services to support physicians participating in emerging models of care, such as patient-centered medical homes, accountable care organizations (ACOs) and other integrated delivery systems.
Medicare’s acceptance of the new codes signals that the agency recognizes the importance of the work involved in transitioning patients from one care setting to the next, and its contributions towards improving the overall quality of healthcare, AMA officials say.
Source: American Medical Association, January 22, 2013
2012 Healthcare Benchmarks: Reducing Hospital Readmissions presents market research on current and planned programs to reduce readmissions, and is supported by more than 40 charts and graphs assembled from responses to HIN’s third annual survey on Reducing Hospital Readmissions conducted in February 2012.