Chronic & Transitional Care Management Minutes and Deadline Calculator
Two engines: sum a calendar month's care-coordination minutes against the CCM thresholds, or turn a hospital discharge date into the TCM contact deadline, 7/14-day visit windows and 30-day service period.
CMS Thresholds Behind the Calculator (MLN909188 + MLN908628)
From CMS booklet MLN909188, Chronic Care Management Services (June 2025): non-complex CCM begins at the first 20 minutes of clinical-staff time in a calendar month, with each additional 20 minutes as an add-on; practitioner-personal CCM begins at 30 minutes with 30-minute add-ons; complex CCM begins at 60 minutes with 30-minute add-ons. Minutes never carry across months and no minute may be counted twice. From MLN908628, Transitional Care Management Services (Aug 2025): interactive contact within 2 business days of discharge (weekends excluded here; your holiday calendar controls), medication reconciliation no later than the face-to-face visit, visit within 7 days for the high-complexity pattern or 14 days for at-least-moderate, inside a 30-day service period that starts at discharge.
KX modifier threshold: have you crossed $2,480 this year?
For CY 2026 the KX threshold is $2,480 for PT and SLP combined and $2,480 separately for OT (CMS Therapy Services CY 2026 update; re-confirmed at each November re-check). Crossing it is not a cap and not permission: append KX only on claims where continued therapy is medically necessary and the record documents it. The year-to-date fields in the allocator above run this check on every calculation.
Frequently Asked Billing Questions
A patient reached 19 CCM minutes in October and 25 in November. What bills?
Nothing for October (the 20-minute threshold was not met and minutes do not roll over), and the first-threshold CCM pattern for November based on November's 25 minutes alone.
Related Medical Coding & Unit Calculators
Free JW/JZ calculator: enter dose, vial size and HCPCS unit to get exact Medicare claim lines, including the sub-unit trap where JW is prohibited and JZ is required.
99417 vs G2212 TimeEnter total minutes: see instantly whether AMA CPT pays 99417 or 99292 and where CMS Medicare denies it (G2212 at 89/69 min, 99292 at 104 min). Free, no sign-up.
Anesthesia UnitsCalculate anesthesia base + 15-minute time units for Medicare ($20.4976, 0.1 rounding, no P-status) vs commercial payers, with AA/QK/QX/QY/QZ direction splits.
PT/OT 8-Min & CQ/COPool timed minutes across CPT codes the CMS way, compare AMA per-code units, and flag CQ/CO when a PTA/OTA passes 10%. Free therapy allocator with audit note.
NDC 10→11 ConverterConvert FDA 4-4-2, 5-3-2 and 5-4-1 package NDCs to the 11-digit 5-4-2 claim format with NCPDP quantity and Loop 2410 LIN/CTP output. Rejects unhyphenated codes.
Global PeriodEnter a surgery date and CMS global indicator (000/010/090) to get the exact global window, then decide modifiers 24/25/57/58/78/79 with a copy-ready audit note.
PBM Days' SupplyCalculate audit-defensible days' supply for tablets, insulin pens (with your PBM priming units), eye drops (your drops/mL) and inhalers. Formulas only, no hidden PBM values.
Infusion TimeTurn documented infusion minutes into initial, additional-hour, sequential and concurrent units for chemo, therapeutic and hydration families, with the >30-minute rule applied.
Therapy MPPREstimate the CMS multiple procedure payment reduction on same-day therapy: highest-PE unit paid in full, PE of later units halved. Work and malpractice never reduced.
Mod 51 / 50 PayEstimate Medicare multiple-procedure pricing (100%/50%) and bilateral surgery payment by MPFS indicator (150%, 100% or already-priced) with modifier 51/50 claim notes.
Workers' Comp EMREstimate your NCCI experience modification rate from your bureau worksheet (expected losses, W, ballast) and see the annual premium impact of a point of mod.