Cognitive Therapy Coding Changes Effective 1/1/2020

The CY 2020 Physician Fee Schedule Final Rule updates payment policies, rates and provides other provisions for services under the Medicare Physician Fee Schedule (PFS) effective January 1, 2020. Below are changes related to cognitive therapy coding.

Deleted CPT Codes Effective January 1, 2020

97127 Therapeutic interventions that focus on cognitive function (e.g., attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (e.g., managing time or schedules, initiating, organizing and sequencing tasks), direct (one-on-one) patient contact (Report 97127 only once per day)

G0515 Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes

New CPT Codes Effective January 1, 2020

97129 Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; initial 15 minutes (Report 97129 only once per day)

97130 Each additional 15 minutes (list separately in addition to code for primary procedure)

(Use 97130 in conjunction with 97129) 97129 represents the first 15 minutes of therapy. Report 97130 in conjunction with 97129 when therapy extends beyond the first 15 minutes.

(Do not report 97129, 97130 in conjunction with 97153, 97155)

References:

CY 2020 Physician Fee Schedule Final Rule

ASHA