Cognitive Function Intervention CPT Codes

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CPT Codes 97597 and 97598

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CPT Codes 97607 and 97608

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CPT Code 97610

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Online Digital Evaluation Service

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When you see the letter “X” in a new CPT code, this “X” will be replaced by the actual number that is in the CPT code once the American Medical Association (AMA) releases the 2020 CPT codes in early September. The same is true with the letters “NPP” in the 3 new HCPCS codes described above. These letters will be replaced by numbers once the AMA releases the 2020 CPT codes in early September.

2020 Medicare Physician Fee Schedule Conversion Factor

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MIPS 2020

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I hope you found this article informative. To access the proposed rule, click

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8 Comments

  1. Hello,

    For Revising Regulations at §§ 410.59 and 410.60 in simple terms, is CMS looking to create a new threshold cap based on the KX or are they trying to clarify the use of the KX. Having a little trouble understanding this proposal. Thank you.

  2. Are you aware of any group fighting the 15% decrease in reimbursement for PTA’s/OTA’s? This is significant and it doesn’t seem like it is getting much attention. Not only will this affect a business financially but it looks like additional documentation will be required for every medicare patient seen whether a PTA/OTA provides any services or not. Your article states CMS is proposing required documentation explaining the application or non-application of the CQ/CO modifiers for each service furnished that day. The broken record continues “lower reimbursements and additional documentation”.

    • I can tell you our professional organizations are fighting this issue with CMS. Are you a member? You can also submit comments to CMS by the deadline to submit comments which is September 27, 2019.

  3. Can you please clarify this for me? The way that I read your information above is that the PTA/OTA changes that start 1/1/20 will apply to Critical Access Hospitals and the changes scheduled to occur on 1/1/22 will not apply to Critical Access Hospitals. Am I interpreting this correctly? Please advise.

    • Since CAHs are not paid under the Medicare Physician Fee Schedule, the therapy assistant modifiers will not apply to CAHs. I am hoping that CMS will clarify in the final rule CAHs will not need to use the CQ and CO modifiers beginning January 1, 2020. The final rule is due to be released in early November.

  4. Not sure if you can answer this directly but these are for standard Medicare patients like it was for G codes–do you know if Medicare supplements, Medicaid, or commercial insurances are following suit. Reason I am asking wondering if we can build into our EMR to drop the modifiers when they are providing the care–but assume we only want to have on standard Medicare??? Thank you!

    • The proposed rule addressing the new PTA and OTA modifiers only applies to traditional Medicare and no other insurance carriers. With that said, don’t me surprised if other insurance carriers also adopt the new modifiers in the future.

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