New year, new codes for PTs and PTAs: The final 2024 Medicare Physician Fee Schedule adds three current procedural terminology, or CPT, codes for caregiver training without the patient present, and will allow PTs and PTAs to report the codes under Medicare. APTA now offers a practice advisory to help you put those codes to use beginning Jan. 1, 2024.
The focus of the new resource is on three CPT codes: 97550, 97551, and 97552. The codes are designed to address situations in which there is a need to provide caregiver education in the interest of an individual patient or group of patients without the patient present. Beginning Jan. 1, Medicare will cover all three codes in all outpatient/Part B settings including private practice, hospital outpatient, rehabilitation agencies, skilled nursing facilities, and home health. APTA will be advocating for coverage under commercial insurance but it is important that providers check with individual insurers to see if the codes are covered.
The new codes were welcomed by APTA, which collaborated with the American Occupational Therapy Association and the American Speech-Language Hearing Association to create them, submit them to the CPT Editorial Panel, and participate in their valuation.
The advisory includes background on the codes, descriptions of each, documentation requirements, and guidance on how to put the codes to best use. The resource also clarifies the definition of "caregiver" used by CMS in the fee schedule — a key element in understanding when the codes may be used.