The American Medical Association (AMA) has released the calendar year (CY) 2020 CPT codes and there are at least 6 new CPT codes and 6 deleted CPT codes that will impact physical therapists, occupational therapists and/or speech-language pathologists in CY 2020. The new CPT codes will become effective with dates of service on and after January 1, 2020 and be valid for dates of service up to an including December 31, 2020. In addition, the Centers for Medicare and Medicaid Services (CMS) is proposing to change 2 existing CPT codes to an active status meaning that CMS will assign work and practice expense relative value units to these 2 CPT codes.
2020 Deleted CPT Codes
The following CPT codes have been deleted for CY 2020:
2020 New CPT Codes
The following CPT codes have been added for CY 2020:
CPT Codes 97607 and 97608 Proposed Changes for 2020
97607 – Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instruction for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
97608 – Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instruction for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters
CMS is proposing to change these 2 CPT codes to an
To purchase your 2020 CPT Code book, as well as other coding resources, from the American Medical Association, click HERE.
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Is it known if the Medicare version of 97127 is also changing?
My understand was 97532 was replaced by 97127 in 2018 for private insurances to use. 97532 was scrubbed out of CPT. For Medicare G0515 was introduced to bill for Medicare patients. 97127 was to be used for private insurance. This was due to the fact G0515 was a timed code.
Now in 2019 we have the 97129 which is cognitive function first 15 minutes, and 97130 for subsequent 15 minutes. Is this just for commercial insurances and the G0515 is to be used for MC.
Katesel Strimbeck PT, MS, MHA
To clarify, 97129 and 97130 will be effective January 1, 2020. At this time, CMS is proposing to pay for these 2 CPT codes and will most likely delete G0515 from the HCPCS Level II book. We will have to wait for that book to be released.
I accidentally put this question in the wrong section initially! Sorry. With the negative pressure codes 97607 and 97608 possibly being switched to an active status, does that mean it will be covered under physical therapy again because it hasn’t been in the past?
It means that nationally, those 2 codes will have an active status. You would then need to defer to your MAC to see if they will pay for those 2 codes and if there are any special conditions in order for them to pay.