New Medicare Caregiver Training Services (CTS) Codes Effective January 2024

Published in the January 2024 issue of the ISHA Voice

By Jordan Bowman

Jordan is the current ISHA President and the ASHA StAMP representative for Illinois.

Introduction

The Center for Medicare & Medicaid Services (CMS) has approved three new caregiver training codes that SLPs can use without the patient present. The purpose of these codes is to train and involve caregivers to support patients with certain diseases or disorders (e.g., dementia) in carrying out an active treatment plan to support patient success and outcomes. This will be the first time CMS has allowed physician and nonphysician practitioners (SLPs, OTs, and PTs) to bill and receive payment for services without the patient present. ASHA is among many other organizations that advocated for the approval of these codes to support the importance (and the value) of caregiver training by SLPs and other practitioners.

ASHA has a detailed summary of best practice use of the new caregiver training codes on their website and will also be rolling out education specific to these codes. Look for updates and resources from ASHA in 2024. SLPs billing Medicare are encouraged to collaborate with their employer to ensure their electronic health record (EHR) software used for billing and documentation is set up to support the use of these codes.

CTS Codes

CPT Code: 97550

Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face; initial 30 minutes

CPT Code: 97551

Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face; each additional 15 minutes (List separately in addition to code for primary service)

(Use 9X016 in conjunction with 9X015)

CPT Code: 97552

Group caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face with multiple sets of caregivers

References

Medicare Finalizes New Codes, Payment Cuts, Quality Measures, and Telehealth Coverage for 2024. https://www.asha.org/news/2023/medicare-finalizes-new-codes-payment-cuts-quality-measures-and-telehealth-coverage-for-2024/

Caregiver Training CPT Codes Finalized for CY2024. https://www.mcknights.com/blogs/rehab-realities/caregiver-training-cpt-codes-finalized-for-cy-2024/