Two SSAs may bill TCM at the same time only when each SSA is providing a separate billable TCM activity at the same time for the same individual.
Examples of when billing by two SSAs can be allowable:
- Case Transfer Meetings: Both SSAs are participating in the exchange of information required to ensure continuity of services.
- Team Meetings: Each SSA is contributing a distinct, billable service directly related to the individual’s needs or plan.
- Consultation: With SSAs, supervisors, or others, only if each SSA is billing a different activity.
Remember:
- Each SSA must document their activity using a separate service code.
- Each activity must meet the definition of TCM allowable.
Two SSAs billing the same code for the same service at the same time is a coverage exclusion and may result in an audit finding.
If you have questions about anything TCM-related, please contact us at TCMTeam@medicaidbillingsolutions.com.
