Medicare began paying for two new CPT® codes (99495 and 99496) as of January 1, 2013 to report Transitional Care Management (TCM) or follow-up care for patients who have been discharged from the hospital and other health facilities. The new codes can result in a payment increase of 40-45 percent for these visits based on the relative value units (RVUs) that Medicare uses for reimbursement of physician services.
In order to receive the reimbursement for the new CPT®s, the patient or the patient’s home caregiver must be contacted within two days of the patient's discharge, and the provider must see patients with a high complexity medical decision within seven days and patients with a moderate medical decision within 14 days, according to the Centers for Medicare and Medicaid Services (CMS).
Because of the tight timeline, it is nearly impossible to meet this criteria on a paper system. But with pMD, which allows providers to enter in their billing charges and hand-off notes from smartphones, doctors are able to submit discharge information electronically from the patient's bedside to their offices in real time. Their staff is then able to reach out to the patient immediately to schedule a follow-up appointment.
Dr. Craig Sande of Gastroenterology Consultants in Reno, Nev., whose practice now uses pMD to track patient follow ups, remembers the many different systems they used in the past.
“Before pMD, following up with the patients was a variable thing,” Dr. Sande said. “There was no consistency, and for a lot of doctors, no way to track whether the follow-up appointment ever happened. Patients used to fall through the cracks.”
“With pMD, we don’t have to make any phone calls to the office or track anything on paper. The system alerts us when we need a follow up, prompts us to give a time frame for the follow up, and makes sure staff follows up with the patients. It’s easy, and I don’t have to worry about it.”
pMD’s mobile charge capture software supports doctors across multiple specialties by allowing them to enter their patient charges into Android, iPhone, iPad, iPad Mini, and iPod Touch devices at the point of patient care. The patient visit is then visible to other doctors within the practice and can be billed immediately. Doctors using charge capture are increasing their ROI in a time where Medicare cuts, ICD-10, PQRS, and other costs are significantly impacting profitability. pMD increases efficiency and security in a practice through automation and secure text messaging, and it provides free interfaces with most major electronic medical records, hospital information, and medical billing systems, including Allscripts Pro PM, Allscripts Tiger, athenaCollector by athenahealth, Cerner, Epic, GE Centricity (formerly Millbrook and IDX), MEDITECH, NextGen, and Vitera Intergy (Sage). For more information, contact pMD.