Healthcare Billing & Care Program Glossary
Plain-English definitions of the CMS billing codes, care programs, and compliance terms referenced across Positive Check's provider resources. Each entry links to its primary CMS source.
What this section covers
- CMS billing codes — CPT codes used for Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and Transitional Care Management (TCM) programs.
- Care program terms — Definitions of RPM, CCM, TCM, Principal Care Management, and Annual Wellness Visit.
- Compliance terms — HIPAA, Business Associate Agreement (BAA), ePHI, HITECH Act.
- Clinical & operational terms — 30-day readmission, interactive communication requirement, care coordination, patient engagement.
Current entries
CMS billing code
CPT 99495
Medicare TCM code for moderate-complexity post-discharge care.
CMS billing code
CPT 99496
Medicare TCM code for high-complexity post-discharge care.
Care program
Transitional Care Management (TCM)
CMS-reimbursed care model for post-discharge transitions.
Clinical outcome
30-day readmission
Unplanned inpatient admission within 30 days of prior discharge; HRRP context.
Clinical operations
Care coordination
Deliberate organization of patient care activities across participants.
Entries are added on an ongoing basis as Positive Check publishes new provider-facing content. For questions about a term not yet listed, contact our team.