The CMS to conduct provider outreach and education for the Medicare-covered Cognitive Assessment & Care Plan Services for CPT code 99483 to increase awareness of this service and its eligibility requirements.
The CMS sending education document, including a direct mailing, from the Medicare Administrative Contractors (MACs) to eligible clinicians.
For about Medicare-covered Cognitive Assessment & Care Plan Services. The education and mailing will raise general awareness of the benefit and provide information on eligibility and billing.
Eligible Providers
- Physicians,
- Nurse practitioners,
- Clinical nurse specialists,
- Certified nurse-midwives
- Physician assistants
Eligible Patients
- All beneficiaries who are cognitively impaired are eligible to receive the services under the code.
- This includes those who have been diagnosed with Alzheimer’s, other dementias, or mild cognitive impairment. But, it also includes those individuals without a clinical diagnosis who, in the judgment of the clinician, are cognitively impaired.
Evaluation and Management services
- If a physician, or other clinicians eligible to bill Evaluation and Management services, finds a patient shows signs of cognitive impairment during a routine visit.
- Medicare covers a separate visit to more thoroughly assess the patient’s cognitive function and develops a care plan.
- The cognitive assessment includes a detailed history and patient exam. There must be an independent historian for assessments and corresponding care plans provided under CPT code 99483.