Updated Payment Tip Sheet Supports Delivery of Recommended Transition Services

As part of the Georgia Academy’s state contract with Georgia’s Department of Public Health’s Maternal and Child Health, the GAFP encourages members to review this tip sheet for transition services. Got Transition has again partnered with the American Academy of Pediatrics to release the new 2022 Transition Coding and Reimbursement Tip Sheet, which supports the delivery of recommended health care transition services in pediatric and adult primary, specialty, and behavioral health care settings.

The tip sheet includes a listing of transition-related CPT codes and corresponding Medicare fees and relative value units (RVUs), effective as of 2022. It then offers a set of clinical vignettes with recommended CPT and ICD-10 coding as well as detailed CPT coding descriptions for each transition-related code, including new care management codes. The document includes a supplemental table listing each code and who is able to report it, while a separate appendix compares the prolonged services codes and what codes they should be reported with. Finally, the tip sheet offers a letter template that can be customized and sent to payers encouraging recognition of transition-related CPT codes.

For more information about the tip sheet or questions about coding and payment issues related to health care transition, contact Annie Schmidt at ASchmidt@TheNationalAlliance.org

About Got Transition

Got Transition® is the federally funded national resource center on health care transition (HCT). Its aim is to improve the transition from pediatric to adult health care through the use of evidence-driven strategies for clinicians and other health care professionals; public health programs; payers and plans; youth and young adults; and parents and caregivers. Got Transition is a program of The National Alliance to Advance Adolescent Health and is funded through a cooperative agreement from the federal Maternal and Child Health Bureau, Health Resources and Services Administration.