Name of the Procedure:

Targeted Case Management, Each 15 Minutes (HCPCS T1017)

Summary

Targeted Case Management (TCM) is a service that assists individuals in accessing and coordinating necessary medical, social, educational, and other services. It involves a healthcare professional working with the patient to create and implement a care plan tailored to their specific needs, conducted in increments of 15 minutes.

Purpose

TCM addresses complex healthcare needs and social situations that require coordinated management. The goal is to improve healthcare outcomes, ensure timely access to services, and support the patient's overall well-being.

Indications

• Chronic medical conditions (e.g., diabetes, hypertension)
• Mental health disorders (e.g., schizophrenia, bipolar disorder)
• Developmental disabilities
• Recovery from serious injury or surgery
• Social issues such as homelessness, substance abuse, or lack of access to basic services

Preparation

Patients typically do not need specific preparations for TCM. However, they may be asked to bring relevant medical records, a list of medications, and information about current health and social situations to assist in creating a comprehensive care plan.

Procedure Description

1. Initial Assessment: The case manager meets with the patient to assess health, social, and emotional needs.
2. Care Planning: The case manager and patient develop a personalized care plan, setting short and long-term goals.
3. Coordination: The case manager coordinates with healthcare providers, social services, and other relevant entities.
4. Monitoring: Regular follow-ups to assess progress and make necessary adjustments to the care plan.
5. Advocacy: The case manager advocates on behalf of the patient to ensure they receive the necessary services.

Tools: Assessment forms, care plan templates, communication devices.

No anesthesia or sedation is required, as this is not a surgical procedure.

Duration

Each session is billed per 15-minute increment, with the total duration varying based on the patient's needs.

Setting

TCM can be conducted in various settings such as hospitals, outpatient clinics, community centers, or even through home visits.

Personnel

• Case Manager (could be a nurse, social worker, or other qualified healthcare professional)
• Collaborating healthcare providers (e.g., physicians, therapists)

Risks and Complications

There are minimal risks associated with TCM. However, potential risks include:

• Inadequate coordination of care leading to missed appointments or delays in treatment.

• Incomplete or inaccurate assessments affecting the care plan.

  Complications are rare but could involve miscommunication between different service providers.

Benefits

• Improved access to healthcare and social services.
• Enhanced coordination of care leading to better health outcomes.
• Tailored support for complex medical and social needs.
• Reduced stress for the patient and their family by providing a structured plan.

Recovery

No physical recovery is necessary post-TCM sessions. Patients may need to follow specific care plan instructions and attend regular follow-up sessions.

Alternatives

• Self-management with assistance from family or friends.
• Community outreach programs not involving formal case management.
• Independent coordination of services by the patient.

Pros and Cons:

• Alternatives may lack professional oversight and structured planning found in TCM.
• Independent coordination could be overwhelming for patients with complex needs.

Patient Experience

Patients can expect a collaborative and supportive experience aimed at improving their quality of life. They will work closely with the case manager to address their needs and establish a reliable support network. Comfort measures include thorough explanation of the process and continuous support, reducing feelings of isolation and anxiety.