CommercialDocumentationMedium impact
Follow-up care after hospitalization
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice·Physician
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island has updated quality improvement guidance for follow-up care after hospitalization, focusing on the Transitions of Care (TRC) measure. The policy emphasizes four key components: hospital admission notifications, discharge information receipt, patient engagement within 30 days, and medication reconciliation post-discharge, with specific CPT codes identified for transitional care management services.
Action Required
Immediately: Billing team should ensure proper documentation and coding for post-discharge services using CPT codes 99495 and 99496 for transitional care management. Verify that medication reconciliation is clearly documented in medical records and consider using CPT Category II code 1111F for discharge medication reconciliation tracking. Update workflows to capture and scan hospital admission/discharge notifications into patient records.