CMS Clears Up Inconsistent Information on New Caregiver Training Codes

The new caregiver training codes rolled out by the U.S. Centers for Medicare & Medicaid Services on Jan. 1 were accompanied by inconsistencies between the final rule and other CMS guidance. Those inconsistencies have now been clarified by the agency, which has created a resource that supports information already provided by APTA.

A recently released FAQ from CMS now makes it clear that information contained in an APTA Practice Advisory is correct. The APTA resource is designed to help members understand how to use three new CPT codes that address situations in which there is a need to provide caregiver training in the interest of an individual patient or group of patients without the patient present.

The FAQ covers a range of topics, but the primary clarification that had been sought by APTA was about billing individual code versus group codes. CMS confirmed that, as stated in the APTA advisory, the determination for individual or group is not based on the number of caregivers present but on the number of patients represented.

The new CPT codes are the result of a collaborative effort between APTA, the American Occupational Therapy Association, and the American Speech-Language Hearing Association to create the codes, submit them to the CPT Editorial Panel, and participate in their valuation.