Transition of Care Management codes 99495-99496

We are a specialist office and have never billed these two codes. I am reading in the CPT® 2013 descriptors of these codes but it is very confusing. Can I get a specific way in which a specialist may bill and what is required in order to bill these two codes?

re: Transition of Care Management codes 99495-99496

The CPT® transition care codes can be reported by a physician or other qualified health care professional and/or licensed clinical staff under the physician’s direction. The codes encompass one face-to-face visit with the patient after discharge and the non-face-to-face care provided during the service period of 30 days. If more than one face-to-face visit occurs within the reporting period, that visit is to be reported separately. CMS proposes that the post-discharge transitional care HCPCS code be payable only once in the 30 days following a discharge, per patient per discharge, to a single community physician or qualified nonphysician practitioner (or group practice) who assumes responsibility for the patient’s post-discharge transitional care management. The claim would be paid at the conclusion of the 30-day post-discharge period.

re: Transition of Care Management codes 99495-99496

Read the article on the site:

http://codapedia.com/article_598_Transitional-Care-Management-Services-TCM-UPDATE.cfm