• AAFP Transitional Care Management Toolkit

    Elements of the 2021 AAFP TCM Toolkit

    The AAFP Transitional Care Management (TCM) Toolkit provides information and templates to help your practice adopt the necessary requirements to bill for TCM services.

    TCM Components and Requirements (64 KB PDF)

    Learn about the components and requirements to successfully implement and get reimbursed for TCM services in your practice.


    Steps to Implement TCM (66 KB PDF)

    Follow these steps to implement TCM services in your practice.


    TCM Script for Staff (59 KB PDF)

    Download this script to help your practice staff successfully perform TCM follow-up calls.


    TCM 30-Day Worksheet (75 KB PDF)

    Use this 30-day worksheet to track patients' status and progress when transitioning from inpatient to the community setting.


    TCM Medical Records Request Form (46 KB PDF)

    Download and fill our this form to request TCM medical records.


    TCM Patient Brochure (50 KB PDF)

    This brochure helps your patients understand how to get the care they need upon discharge from an inpatient setting.