Interactive contact
Your team must reach the patient or caregiver within 2 business days of discharge. Two or more documented, timely attempts can satisfy the rule if everything else is met.
Two business days, one visit, one payable claim
TCM covers the 30 days after a patient leaves the hospital or a skilled nursing facility. Medicare pays the first eligible claim for that period, so a missed contact window or a late visit can erase a month of follow-up work.
Book a demoThe clock that decides a TCM claim
CMS describes TCM in its MLN booklet and billing FAQs. The timing rules are strict.
Visit timing and complexity
99495 needs at least moderate medical decision making and a face-to-face visit within 14 calendar days. 99496 needs high complexity and a visit within 7 days. The visit itself is not billed separately.
Date of service
The claim carries the date of the face-to-face visit and can go out once that visit happens. Only one practitioner is paid per 30-day period, and Medicare pays the first eligible claim.
Hand off the claim, keep the follow-up
Discharge alerts, nurse calls, and the visit all happen before billing sees anything.
What the practice keeps
Discharge notifications, the 2-day contact, medication reconciliation by the visit date, and the visit itself stay with your clinical team.
What Taiga takes on
Taiga drafts the TCM code from the visit note for physician approval, checks eligibility, submits the claim, and appeals denials, including ones caused by another practitioner billing the same period.
Where a decision is needed
Someone has to decide what happens when a surgeon's global period overlaps the 30 days, the patient is readmitted, or the patient dies before day 30.
Questions for a TCM fit call
Bring de-identified examples of a paid TCM claim and one that was denied. Leave patient details out of the booking form.
How do you hear about discharges?
Describe whether alerts come from hospitals, a health information exchange, or patients calling in.
Who makes the first call?
Name the role that contacts patients and where the attempts are documented.
How often do visits slip past day 14?
Explain what happens today when the visit window is missed and whether those visits are billed as regular E/M instead.
For practices that see patients after discharge
Useful for a primary care or internal medicine group that already does post-discharge visits but is unsure TCM claims are going out, getting paid, or getting appealed.
The clinical clock is yours
Taiga cannot make the 2-day contact or schedule the visit. This page reflects CMS guidance for Medicare and does not settle how other payers treat TCM.
Questions about TCM billing
Can we bill TCM if we couldn't reach the patient within 2 business days?
Yes, if you made two or more timely, documented attempts and met every other requirement, including the visit window. CMS still expects you to keep trying until you reach the patient.
Can the TCM visit be done by telehealth?
CMS says you can provide 99495 and 99496 through telehealth. Check each commercial plan's own telehealth policy before relying on that outside Medicare.
What if another doctor bills TCM first?
Medicare pays only the first eligible TCM claim for the 30-day period. Other practitioners can still bill medically necessary E/M visits during that time.
Can TCM be billed during a global surgery period?
Not by the same practitioner. CMS does not pay TCM if any part of the 30 days falls within a global period for a procedure that practitioner billed.
Bring your discharge follow-up process
Walk Taiga through how a discharge becomes a visit and a claim in your office. You will get a straight answer on fit.
System guides show possible billing handoffs, not proven specialty compatibility.