If cognitive assessment identifies cognitive impairment, what's next? Cognitive care planning.

In our prior posts, we’ve covered the 2019 changes to coding for neurocognitive testing. If testing identifies cognitive impairment, what’s next? Cognitive care plans can aid the physician in guiding the patient and family through the often challenging stages of this condition.

In 2017, after considerable urging by the Alzheimer’s Association and others, the Centers for Medicare & Medicaid Services (CMS) formally approved coverage for developing a cognitive care plan and providing the care plan to the patient/family/caregiver.

The new code, CPT 99483, replaces temporary code G0505 and took full effect in 2018. The updated 2019 Medicare Physician Fee Schedule shows a base payment of $263.81 before geographical adjustment.

Rationale for Medicare adding coverage for cognitive care plans

The rationale for the new service code is multi-faceted. Early recognition of cognitive impairment and intervention for modifiable risk factors may prevent or delay progression of dementing illnesses.

Consequently, encouraging physicians via a reimbursable service to provide a care plan for cognitive impairment may promote detection and intervention while treatment options are still viable. In addition, CPT code 99483 requires involvement of caregivers and multi-disciplinary resources, organized in an individualized written plan to guide and educate patients and their loved ones through the course of the illness.

Recognition of caregiver stress, safety risks, and end-of-life preferences are critical factors in preserving quality of life and the ability to maintain independent living as long and as safely possible.

In our next post, we will detail the requirements for billing CPT code 99483.