Home-Based Medical Care: Advanced Coding Opportunities - 2025

A comprehensive resource to assist home-based medical care providers and practice staff with understanding the advanced coding opportunities beyond Evaluation and Management (E/M) Current Procedural Terminology (CPT®) codes that are available billing and reimbursement based on the high level of complexity of patient needs. These 2025 CPT codes align with the care provided and allow providers to maximize Medicare Fee-for-Service reimbursement. All content was gathered utilizing Centers for Medicare & Medicaid Services (CMS) guidelines.

Topics include:

• Transitional Care Management (TCM)
• Chronic Care Management (CCM)
• Principal Care Management (PCM)
  
• Caregiver Training
• Prolonged Services
• Community Health Integration (CHI)
• Interprofessional Consult Services
• Cognitive Assessment and Care Plan Services
• Principal Care Management (PCM)
• Smoking Cessation Counseling Services
  
• Online Digital E/M Services (E-visits)
  
• Anticoagulation Management
  
• Advance Care Planning (ACP)
  
• Brief Communication Technology-Based Virtual Check-ins
  
• General Behavioral Health Integration (BHI) Care Management
  
• Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services