AMA praises the addition of 2 new care coordination CPT codes

January 23, 2013 in Medical Technology

The American Medical Association yesterday praised the federal government for creating Medicare CPT codes for care coordination, allowing physicians to be paid for the management of patients who have recently been discharged from a hospital or skilled nursing facility.

The AMA’s CPT editorial panel created two new codes (99495 and 99496) with broad input from the healthcare community to capture transitional care management services, according to AMA officials. The codes allow for efficient reporting of time spent discussing a care plan, connecting patients to community services, transitioning them from inpatient settings and preventing readmissions.

[See also: AMA, CHIME air ‘concerns’ about stage 3.]

Last year the AMA called on the Centers for Medicare Medicaid Services (CMS) to adopt the new codes and cover the related services to support physicians participating in emerging models of care, such as patient-centered medical homes, accountable care organizations (ACOs) and other novel integrated delivery systems.

“Medicare’s acceptance of the new codes signals that CMS recognizes the important role these services have in improving the overall quality of health care,” said AMA President-elect Ardis Dee Hoven, MD, in a statement. “The decision supports the work involved in transitioning patients from one care setting to the next and physicians working in emerging models of care.”

The AMA/Specialty Society RVS Update Committee (RUC) also played an essential role in providing Medicare with insight and recommendations on the value of the work and resources associated with services reported by the new transitional care codes, according to the AMA.

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