Kidney Care Partners Requests CMS Address Medicare Administrative Contractor Implementation of Transitional Care Management Codes, Barriers for Dialysis Beneficiaries
Kidney Care Partners submitted a letter to the Centers for Medicare & Medicaid Services (CMS) regarding a matter that relates to the Transitional Care Management (TCM) codes established in recent years as part of the Physician Fee Schedule and their availability to Medicare dialysis beneficiaries. Specifically, some Medicare Administrative Contractors (MACs) are denying claims for these services when provided by a nephrologist in a dialysis facility (place of service 65), despite CMS never creating such a restriction. This behavior contradicts the efforts the CMS have undertaken during the CY2020 rulemaking cycle to expand the utilization of these codes. Kidney Care Partners requests CMS to eliminate these barriers so that dialysis patients like other Medicare beneficiaries have access to TCM services and can experience the improved outcomes they can provide.