New CPT Codes Support Medicare Payment for Care Coordination


CHICAGO - Jan. 22, 2013 - Medicare is now accepting newly created Current Procedural Terminology (CPT) codes for care coordination to pay physicians for the management of patients who have recently been discharged from a hospital or skilled nursing facility.

The American Medical Association CPT Editorial Panel created new codes (99495 and 99496) with broad input from the health care community to capture transitional care management services. 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.

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, M.D. “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. Recently, RUC members commented on the importance of these new codes http://youtu.be/MQYKPeGiKnM

# # #

Media Contact:
Robert J. Mills
AMA Media Relations
(312) 464-5970
robert.mills@ama-assn.org

About the American Medical Association (AMA)
The American Medical Association helps doctors help patients by uniting physicians nationwide to work on the most important professional, public health and health policy issues. The nation’s largest physician organization plays a leading role in shaping the future of medicine. For more information on the AMA, please visit www.ama-assn.org .

Tags:

About Us

About the American Medical Association (AMA) Since 1847 the American Medical Association has had one mission: to promote the art and science of medicine and the betterment of public health. Today, the core strategy used to carry out this mission is our concerted effort to help doctors help patients. We do this by uniting physicians nationwide to work on the most important professional and public health issues. In 2011 our strategic plan focuses on five areas that encompass the central elements in health system reform: Access to care Quality of care Cost of health care Prevention and wellness Payment models Vist the AMA's 2011 strategic plan at: http://www.ama-assn.org/ama/pub/about-ama/strategic-issues.page These topics represent the major areas of emphasis in which the AMA carries out its mission in the current environment. Our proposed actions are not only directed at solving reform issues at the policy level, but also at helping physicians adapt to—and adopt—changes in a productive way. To learn more about how the AMA is moving medicine forward, read our flyer at: http://www.ama-assn.org/resources/doc/about-ama/moving-medicine-forward.pdf.