Transitional care management (TCM) codes 99495 and 99496 were introduced in Current Procedural Terminology (CPT®) 2013, and an overview of these services was included in the October 2012 AAP Pediatric Coding Newsletter™ article, “CPT 2013 Changes: Chronic Care Coordination and Transitional Care Management.” These codes were established by the American Medical Association (AMA) CPT Editorial Panel as part of an effort to recognize the value of continuity of care offered by the patient-centered medical home. Relative value units (RVUs) recommended by the AMA/Specialty Society Relative Value Scale Update Committee and accepted by the Centers for Medicare & Medicaid Services recognize physician work (2.11 and 3.05 RVUs, respectively) and the practice expense of time spent by licensed clinical staff providing care management services (2.57 and 3.54 RVUs, respectively). These services may represent a valuable source of new revenue for practices that have adopted a team approach to patient...

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