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Chronic Care Management with Transitional Care Management Clarification
TCM policy indicates that it is billable in the same month that CCM services are performed. MLN® Booklet Transitional Care Management Services includes a listing of the services that fit this category.
While CCM services are payable during the same month as TCM there is also a NCCI edit in place that does not allow CPT 99491, “CCM provided personally by a physician or other qualified health care professional, per calendar month,” to be payable on the same date that TCM services are billed.
Based on these different policies we want to make providers aware that while TCM and CCM services may be allowed when provided during the same month, 99491 will not be allowed when billed on the same day as the TCM service.