Wednesday, Jan. 23, 2013
This Week's News
This Week's News
New CPT® codes support physician payment for Medicare care coordination
Physicians who coordinate care for Medicare patients recently discharged from a hospital or skilled nursing facility now can report new Current Procedural Terminology® (CPT®) codes to receive Medicare payment for these services.
Effective Jan. 1, Medicare will cover transitional care management services included in two new CPT codes: 99495 and 99496. These codes allow physicians to efficiently report time spent discussing patient care plans, connecting patients to community services, transitioning them from inpatient settings and preventing readmissions. The codes were created by the AMA CPT Editorial Panel with broad input from the health care community.
"Medicare's acceptance of the new codes signals that the Centers for Medicare & Medicaid Services (CMS) recognizes the important role these services have in improving the overall quality of health care," AMA President-elect Ardis Dee Hoven, MD, said in a news release. "The decision supports the work involved in transitioning patients from one care setting to the next and physicians working in emerging models of care."
Last year the AMA had called on CMS to adopt the new codes and cover the related services to support physician participation in emerging models of care, such as patient-centered medical homes, accountable care organizations and other novel integrated delivery systems.
The AMA/Specialty Society RVS Update Committee (RUC) also played an essential role in providing Medicare with recommendations on the value of the work and resources associated with services included in the new codes. Watch a new video in which RUC members comment on the importance of these new codes.