This article includes information primarily from the 2024 Physician Fee Schedule Final Rule, but also the 2025 OPPS Fee Schedule in order to address … [Read more...]
Care Plan Oversight | Coding reference sheet
There are two sets of codes for care plan oversight, CPT® (99374–99380) and HCPCS codes (G0181, G0182). The requirements for each are different, … [Read more...]
Consent for Communication Technology-Based Services (CTBS)
Both CPT and CMS have developed codes for non-face-to-face communication-based technology services in recent years. In addition to care management … [Read more...]
Psychiatric Collaborative Care Management Services
Psychiatric Collaborative Care Management Services 99492, 99493, 99494 Care Management for Behavioral Health 99484 PCCM quick reference … [Read more...]
Is ChatGPT Coming to Coding?
Question: What’s all this I hear about ChatGPT? Is it coming to coding? Answer: All right, I wrote that question myself. I’ve been thinking … [Read more...]
CMS Finalizing Principal Illness Navigation (PIN) Services
This is information from the 2024 Physician Fee Schedule Final Rule https://public-inspection.federalregister.gov/2023-24184.pdf CMS developed … [Read more...]
CMS Adopts Codes for Caregiver Training Services (CTS)
This is information from the 2024 Physician Fee Schedule Final Rule, published Nov. 2, 2023. You can read it for yourself by downloading the pdf … [Read more...]
Chronic Care Management | Reference Sheet
This quick reference sheet includes clinical staff time, care planning and billing practitioner work criteria for chronic care management services. … [Read more...]
Principal Care Management (PCM) Services – CPT codes 99424—99427
There are four principal care management codes 99424 and 99425 are for time spent by a physician or other qualified health care professional … [Read more...]
Chronic Care Management
Medicare and private payers cover chronic care management services if a patient has two or more serious conditions that are expected to last at least … [Read more...]
Transitional Care Management
This article provides answers to frequently asked questions related to transitional care management services. It includes details about billing for … [Read more...]
Outpatient Diabetes Self-Management Training (DSMT) Services
Diabetes self-management training (DSMT) services are a covered benefit under Medicare when all requirements are met. This article will provide an … [Read more...]
Coding for Medical Nutrition Therapy Services
Medical Nutrition Therapy Services (MNT) have been a covered benefit under Medicare since the early 2000’s. This article will describe the rules … [Read more...]
Anticoagulation Management
Currently, there are two sets of codes, three HCPCS codes and two CPT® codes. They aren’t defined exactly the same, and so take careful reading. The … [Read more...]
Checklist for CPT® code 99483 | cognitive assessment code for dementia
Is your practice performing cognitive assessments for patients with dementia, using CPT® code 99483? Primary care and neurology practices are likely … [Read more...]
Advance Care Planning | CPT® 99497, 99498
Advance Care Planning (ACP) 99497 Advance care planning including the explanation and discussion of advance directives such as standard forms (with … [Read more...]
Don’t forget Care Plan Oversight
There are two sets of codes for care plan oversight, CPT® (99374–99380) and HCPCS codes (G0181, G0182) The requirements for each are different, … [Read more...]
Coding Guide – Care Management Services
CMS has a stated goal of recognizing management services provided outside of an office visit. In particular, valuing and paying for care management … [Read more...]
CPT® Code 99483: Cognitive Assessment and Care Plan Services
Developed in 2018, this service describes an in-depth assessment and development of care plan services for new or established patients who have signs … [Read more...]
Certification for Home Health Services
There are two HCPCS codes that physician, nurse practitioners, clinical nurse specialists and physician assistants can use to report developing a plan … [Read more...]
Can I Get Paid for…Signing the Home Health Certification Form
An Overview of Home Health Certification CPT® CMS pays a small fee for the planning, certification, supervision and re-certification of home health … [Read more...]