What is the basis of coding case management reimbursement?

The correct answer is based on understanding the comprehensive approach taken in coding for case management reimbursement. The reimbursement model acknowledges both face-to-face services and non-face-to-face services rendered by case managers. This includes various interactions and interventions that are essential for the effective management of a patient's care, such as phone calls, care coordination, and follow-up activities, alongside the in-person visits.

This comprehensive coding approach recognizes the value added by case managers in navigating the healthcare system, facilitating access to necessary services, and ensuring continuity of care, which can significantly impact patient outcomes. As such, accurate coding that reflects all the services—both direct and indirect—is crucial for effective reimbursement and sustaining case management programs.

In contrast, the other options are too restrictive or focused on narrow aspects of case management. For instance, payment for administrative support only overlooks the clinical interactions and essential patient care activities. Limiting reimbursement to services during hospitalization ignores the fact that much of case management work occurs outside of acute care settings. Traditional models may not encompass the evolving and multifaceted nature of case management in today's healthcare environment, where a broader array of services is recognized for reimbursement.