Care Plan Oversight, High Complexity

Transitional care management is essential in ensuring a smooth transition for patients, requiring precise coding to capture the comprehensive nature of transitional services. CPT code 99484 designates transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge and medical decision-making of at least high complexity during the service period. This code is applied when healthcare providers engage in transitional care management services, including communication with the patient or caregiver within 2 business days of discharge and medical decision-making of at least high complexity.

CPT code:

99484

Category:

Category I

Section:

Explore Evaluation and Management CPT Codes

Specialty:

Cognitive Assessment and Care Plan Services

Type:

Cognitive Assessment and Care Plan Services

In the realm of transitional care management, 99484 plays a crucial role, representing services that include communication with patients or caregivers within 2 business days of discharge and medical decision-making of at least high complexity. Healthcare providers utilize this code to ensure accurate documentation of efforts in the comprehensive management of patients transitioning from one care setting to another.

Under what category does Care Plan Oversight, High Complexity fall?

Category I

What is the billing unit for Care Plan Oversight, High Complexity?

Per Encounter

Modifiers

Clinical use

Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified healthcare professional, per calendar month.

Documentation

Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified healthcare professional, per calendar month. Document the behavioral health conditions addressed, the clinical staff time spent, and the specific care management interventions provided. (each additional 20 minutes)