Monday September 16th 2019

ANA offers guidance on new Medicare billing codes

The American Nurses Association (ANA) is providing educational resources to help RNs and advanced practice registered nurses (APRNs) learn how to incorporate new Medicare payment policies for core nursing services into their practices.

The new Medicare payment policies for “transitional care management” and “complex care coordination” services went into effect Jan. 1. Under the Medicare Physician Fee Schedule Final Rule, Medicare will reimburse for transitional care management services in the first month after high-need patients are discharged from the hospital. Nurse practitioners, clinical nurse specialists and certified nurse-midwives (as well as physicians and physician assistants) are eligible to bill for transitional care management services.

Additionally, the Medicare rule recognizes new billing codes for complex chronic care coordination, which includes care coordination activities typically provided by RNs or APRNs. However, the Centers for Medicare and Medicaid Services currently will not separately pay for complex care coordination services.

To assist its members, ANA has compiled Frequently Asked Questions that explain the new codes, which are posted on ANA’s web page on care coordination at An educational webinar is being presented on Feb. 20.

Mental health code resources

With the changes, Medicare adopted major new coding and reimbursement policies for psychiatric and mental health services. The new psychiatric codes apply to psychiatric/mental APRNs and other mental health providers.

ANA collaborated with its organizational affiliate, the American Psychiatric Nurses Association (APNA), to develop educational webinars about the new psychiatric codes and reimbursement. The webinars are available on APNA’s website at, free to members and nonmembers.

ANA resources

To learn more about Medicare billing codes and care coordination, visit ANA’s Web page on care coordination at

Sign up for the 2013 Psychiatric Service Codes webinars at

More from category

ANA’s policy development process – for and by ANA members

Member involvement in the development of professional policies is critical. Your voice can and should be heard in the [Read More]

Addressing the challenge of medication errors
Addressing the challenge of medication errors

Earlier this year, a study and analysis by industry experts at Johns Hopkins revealed that medical errors are the [Read More]

ANA welcomes U.S. Supreme Court decision on women’s health
ANA welcomes U.S. Supreme Court decision on women’s health

The American Nurses Association hailed the 5-3 decision by the U.S. Supreme Court June 27 in the Whole Woman’s [Read More]

Tackling nation’s opioid epidemic
Tackling nation’s opioid epidemic

In what is being hailed as the most sweeping drug addiction legislation in years, Congress mustered a bipartisan effort [Read More]

Texas nursing program teams up with Meals on Wheels
Texas nursing program teams up with Meals on Wheels

The psychosocial risks for dementia and Alzheimer’s disease among the underserved and disadvantaged elderly [Read More]