August 5, 2021
An annual comprehensive visit can be used for health maintenance screening, health risk assessment, and addressing chronic conditions. One of the screening questions is related to memory and, due to the high prevalence of memory related issues, the screen is frequently positive. Addressing a positive memory screen can be time consuming in evaluation but also in developing a management plan. Consider using a visit for cognitive assessment and care plan services described in the following Centers for Medicare & Medicaid Services
communication:
Cognitive Assessment: What's in the Written Care Plan?
Do you have a patient with a cognitive impairment? Medicare covers a separate visit for a cognitive assessment so you can more thoroughly evaluate cognitive function and help with care planning. Any clinician eligible to report evaluation and management services can offer this service, including physicians (MD and DO), nurse practitioners, clinical nurse specialists, and physician assistants.
The Cognitive Assessment and Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam. Use information you gather from the exam to create a written care plan.
The resulting written care plan includes initial plans to address:
- Neuropsychiatric symptoms
- Neurocognitive symptoms
- Functional limitations
- Patient or caregiver referrals to community resources, as needed, with initial education and support
Effective January 1, 2021, Medicare increased payment for these services to $282 (may be geographically adjusted) when provided in an office setting, added these services to the definition of primary care services in the Medicare Shared Savings Program, and permanently covers these services via telehealth.
Get details on Medicare coverage requirements and proper billing at cms.gov/cognitive.
For patients who have neuropsychiatric symptoms, consider a consultation with behavioral health resources in your organization or with Optum Behavioral Health (800-711-4577), a service available to Premera Medicare Advantage members.