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TCM Billing Process
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1/14/2021 @ 3:52:00 PM
Post 1 of 2

Contributor: cathy.harte@sih.net

For those RHCs billing TCM services, are you billing the TCM procedure code with the date of the face-to-face encounter, but held until the 30-day post discharge period is met?  So for example, TCM services are provided to a highly complex patient with the face-to-face visit (99496) on post-discharge day 5 (01/5), do you hold the claim (1/31) to ensure all conditions for the service are met?  

Thank you all,

Cathy L Harte, CMPE

1/14/2021 @ 4:16:00 PM
Post 2 of 2

Contributor: Cassie Beesley, Springfield Clinic - Hillsboro East

That I what we are doing. We have it set to hold all TCM codes and then we review for compliance at 30 days and submit TCM if meets compliance and if not we change it to an E/M code and bill. The date is the date of the face-to-face visit.

[cid:image003.png@01D4EA20.04F19020] Cassie Beesley, CRHCP
Rural Health Clinic Manager
Springfield Clinic
Phone 217.528.7541 x44801

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