Newsletters

POSTED: June 27th, 2021
POSTED IN: EM Pulse - The Official Newsletter of MOCEP, May/June 2021,

According to the Alzheimer’s Association 2021 Alzheimer’s Disease Facts and Figures, in 2021, more than 1 in 9 people (11.3%) aged 65 years and older has Alzheimer’s dementia, costing the nation $355 Billion and killing more people than breast cancer and prostate cancer combined. 

In light of this, we wanted to ask for your assistance in raising awareness and appropriate use of CPT code 99483 Cognitive Assessment and Care Plan Services​, Medicare-covered services to detect and diagnose cognitive impairment.

 Background:

Medicare covers a separate visit for a cognitive assessment to allow clinicians to more thoroughly evaluate cognitive function and help with care planning for patients with cognitive impairment. 

Effective January 1, 2021, CMS:

·       Increased payment for these Medicare 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.

Clinicians who report evaluation and management (E/M) services, including: physicians (MD and DO), nurse practitioners, clinical nurse specialists, and physician assistants, can offer and bill Medicare for this service; and the assessment can be provided in a number of locations such as in the home, an office or outpatient setting, care facility, or via telehealth.

The assessment, which is typically a 50 minute, face-to-face visit, includes a detailed history and patient exam, resulting in a written care plan to address neuropsychiatric symptoms, functional limitations and referral to community resources as needed.

Resources Available:

We have several resources that may be helpful to share with your stakeholders through newsletters, listservs, or other communications including:

·       The CMS webpage on Cognitive Assessments and Care Plan Services: www.cms.gov/cognitive,

·       An MLN Fact Sheet,

·       A video for basic information on coverage, eligibility, and billing for Cognitive Assessment and Care Plan Services,

·       Our letter (PDF) to eligible health care providers, and

·       Alzheimer’s and Dementia Resources for Professionals .