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Transitional Care Management

TCM Software to Track Every Discharge and Bill 99495/99496 Confidently

Real-time discharge tracking, automated 2-day contact workflows, and complete TCM billing — all in one platform.

TCM Dashboard

Measurable Outcomes for Transitional Care Management Programs

The 30 days after hospital discharge is when patients are most vulnerable to readmission — and when TCM generates its highest clinical and financial return. Most practices miss over half of their billable TCM opportunities simply because they don't have a system to track discharges in real time.

Revenue Per Episode

$165–$234

Medicare Reimbursement Per TCM Episode (99495: ~$165 / 99496: ~$234)

30-Day Readmissions

−32%

Average Reduction in 30-Day Readmissions with Active TCM Follow-Up

Missed Opportunities

54%

Of Billable TCM Episodes Are Missed by Practices Without Discharge Tracking

Medication Errors

−41%

Reduction in Post-Discharge Medication Errors with Structured Reconciliation Workflows

Features

A Comprehensive Feature Pack for Your Transitional Care Management Platform

From real-time hospital ADT discharge feeds and automated 2-business-day contact workflows to structured medication reconciliation, face-to-face visit scheduling, and 99495/99496 claim generation — Vervelo manages every TCM deadline automatically.

Transitional Care Management

Real-Time Discharge Notification Tracking
Discharge Tracking

ADT feeds from hospitals and SNFs alert coordinators to every discharge in real time — with countdown timers for 2-day and 7/14-day deadlines built into the worklist.

Transitional Care Management

2-Business-Day Interactive Contact Workflow
2-Day Contact

Automated outreach triggers immediately on discharge. Coordinators document interactive contact with CMS-required detail. Escalation rules catch non-responders before the deadline.

Transitional Care Management

Structured Medication Reconciliation
Medication Reconciliation

Discharge med list vs. home med comparison flags discrepancies and high-risk medications. Structured teach-back documentation ensures patient education is captured.

Transitional Care Management

Automated 99495/99496 Billing
TCM Billing

Auto-selects 99495 or 99496 based on complexity. Tracks face-to-face visit requirements. Produces complete audit-ready documentation packages for every claim.

Why Vervelo for Transitional Care Management

Built for primary care practices that need to catch every discharge, meet every CMS deadline, and bill every TCM episode with confidence.

HIPAA Compliant
HIPAA Compliant

All discharge data, contact records, medication reconciliation logs, and billing documentation are encrypted and stored with role-based access controls.

Real-Time ADT Feeds
Real-Time ADT Feeds

Live hospital and SNF discharge notifications mean no discharge goes unnoticed — and no TCM billing window silently closes before you know a patient was hospitalized.

EHR Compatible
EHR Compatible

Bi-directional EHR integration keeps discharge notes, medication lists, and visit documentation in sync with your existing system — no duplicate charting.

Deadline Automation
Deadline Automation

From the 2-day contact window to the 7-day or 14-day face-to-face requirement, Vervelo tracks every TCM deadline automatically and alerts staff before windows close.

Primary Aims of Vervelo Transitional Care Management

TCM is CMS's highest-reimbursed care management code — and the most time-constrained. Every TCM capability in Vervelo is designed around these core outcomes.

01
Reduce 30-Day Readmissions

Structured post-discharge follow-up, medication reconciliation, and early warning identification are the evidence-based interventions that prevent the avoidable readmissions that trigger CMS penalties.

02
Capture Every Billable TCM Episode

Real-time discharge tracking and automated deadline management ensure that no 99495 or 99496 billing opportunity is missed — converting a chaotic reactive process into a systematic revenue stream.

03
Eliminate Medication Errors at Discharge

The transition home is the highest-risk moment for medication errors. Structured discharge-to-home medication reconciliation with clinical review closes the most dangerous gap in transitional care.

04
Meet All CMS TCM Requirements

2-day interactive contact, face-to-face visit within the complexity window, medication reconciliation, and comprehensive care management — Vervelo tracks and documents every CMS-required element.

05
Identify New VBC Program Opportunities

A hospitalization often signals a patient whose chronic conditions are not well-controlled. Vervelo automatically flags newly eligible CCM, RPM, or BHI patients identified through TCM — converting a crisis into a long-term enrollment.

06
Reduce CMS Readmission Penalties

Under the Hospital Readmissions Reduction Program, practices and hospitals share accountability for readmission rates. Systematic TCM directly reduces the events that trigger shared savings penalties.

120+ Healthcare Organizations Trust Vervelo

Across TCM, CCM, RPM, BHI, AWV, PCM, and APCM programs

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Transitional Care Management in Practice

Real results from practices using Vervelo's TCM platform.

CarePlus Telehealth
Readmission Reduction
CarePlus Telehealth

Reduced 30-day readmissions by 34% across 800 high-risk Medicare patients using Vervelo's discharge tracking and structured follow-up workflows.

Grandview Hospital Medical Group
TCM Revenue Capture
Grandview Hospital Medical Group

Increased TCM billing from 12% to 89% of eligible discharge episodes — adding $41,000/month in 99495/99496 revenue previously left on the table.

HealthBridge Primary Care
Medication Safety
HealthBridge Primary Care

Identified and resolved medication discrepancies in 63% of post-discharge reconciliations — including 14 high-risk anticoagulant errors caught before harm occurred.

Built to Meet Healthcare's Highest Compliance Standards

HIPAA Compliant GDPR HL7 FHIR SOC 2 Type II Vervelo Certified
Vervelo

Ready to Capture Every TCM Billing Opportunity?

Talk to a Vervelo TCM specialist. We'll analyze how many discharge episodes your practice is currently missing and show you exactly what the TCM revenue opportunity looks like for your patient panel.

TCM revenue opportunity analysis based on your discharge volume

Projected 99495/99496 billing uplift and readmission cost savings

ADT feed setup and EHR integration assessment

Get a Free TCM Revenue Assessment

Frequently Asked Questions

Common questions about Transitional Care Management and Vervelo's TCM platform.

What is the difference between 99495 and 99496? +
Both codes are billed for the 30-day period following discharge from a hospital, SNF, or partial hospitalization. 99495 (moderate medical decision-making complexity) requires the face-to-face visit within 14 calendar days. 99496 (high medical decision-making complexity) requires the face-to-face visit within 7 calendar days. Vervelo automatically recommends the appropriate code based on the discharge diagnosis and MDM complexity — ensuring you never underbill a high-complexity case.
What counts as an 'interactive contact' within 2 business days? +
CMS requires that the 2-day contact allow the patient (or authorized caregiver/guardian) to communicate back — making it an interactive exchange rather than one-way communication. Phone calls, video visits, and in-person contacts all qualify. A one-way voice message or an automated text does not satisfy the requirement by itself. Vervelo's contact documentation workflow captures the method, duration, and participants of every contact to ensure billing compliance.
Can TCM be billed the same month as CCM or RPM? +
TCM (99495/99496) and CCM (99490) cannot be billed for the same patient in the same calendar month, per CMS rules. However, TCM can be billed alongside RPM codes for the same patient in the same month, provided the services are distinct. After the 30-day TCM period ends, CCM billing can resume for the following month. Vervelo's billing engine automatically prevents co-billing conflicts that would result in claim denials.
What staff can perform TCM services? +
TCM services are generally performed by licensed clinical staff under physician supervision — including RNs, LPNs, care managers, and social workers. The 2-day interactive contact and care management activities during the 30-day period can be delegated to clinical staff, but the face-to-face visit must be with a physician, PA, NP, or CNS. Vervelo's role-based workflows are designed for exactly this team-based TCM delivery model.
How quickly can we go live with TCM? +
Most practices are live with TCM within 1–2 weeks. The critical path is setting up ADT discharge notification feeds from your local hospitals — a process Vervelo's integration team manages on your behalf. Once feeds are live, coordinators receive immediate discharge alerts and can begin the TCM workflow the same day. Staff training typically takes 2–3 hours and can be completed remotely.