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.
Use CPT code 99483 Cognitive Assessment and Care Plan Services
Materials can be found at the following links:
