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AMA News Room

Jan. 22, 2013

New CPT Codes Support Medicare Payment for Care Coordination

For immediate release:
Jan. 22, 2013

CHICAGO - Medicare is now accepting newly created Current Procedural Terminology (CPT) codes for care coordination to pay physicians for the management of patients who have recently been discharged from a hospital or skilled nursing facility.

The American Medical Association CPT Editorial Panel created new codes (99495 and 99496) with broad input from the health care community to capture transitional care management services. The codes allow for efficient reporting of time spent discussing a care plan, connecting patients to community services, transitioning them from inpatient settings and preventing readmissions.

Last year the AMA called on the Centers for Medicare & Medicaid Services (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 novel integrated delivery systems.

“Medicare’s acceptance of the new codes signals that CMS recognizes the important role these services have in improving the overall quality of health care,” said AMA President-elect Ardis Dee Hoven, M.D. “The decision supports the work involved in transitioning patients from one care setting to the next and physicians working in emerging models of care.”

The AMA/Specialty Society RVS Update Committee (RUC) also played an essential role in providing Medicare with insight and recommendations on the value of the work and resources associated with services reported by the new transitional care codes. Recently, RUC members commented on the importance of these new codes.



Robert J. Mills
American Medical Association
(312) 464-5970

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