Billing Transtion of care to BCBS

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Can any one tell me why BCBS is denying transition of care codes ( 99495 -99496 ) . I have been getting paid from other insurance , I cant get BCBS to pay these codes. Can any one help with this. Thank you
 
Bcbs tcm

I am having the same problem. The explanation they give makes no sense. Does anyone have any insight to offer?

Thanks!
 
Anthem BCBS does not cover TCM codes.
These most likely will need to be billed out as EM codes if appropriate.
 
TOC is a non-covered service under BCBS. We went through this a year ago & had the same confusion because they had Cpt codes 99495 & 99496 on their fee schedule.
We received clarification from our Provider Rep & TOC is definitely non-covered. You will have to bill these visits following E/M coding guidelines.

Perhaps they will cover TOC in 2017. I know under best practices thre are only a handful of codes that will be payable in 2017 and the rest will fall under capitation. We'll have to wait and see.
 
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