Medical coders must familiarize themselves with several new codes for Caregiver Training Services, which became effective January 1, 2024. These new services are intended to improve patient treatment outcomes.
Caregiver Training
This service is intended to provide skilled, interventional training in techniques and skills necessary to assist patients with functional disabilities. The patient is not present during the training.
CMS has also defined “Caregiver” in the FY2024 Final Rule:
“After considering the public comments, we are finalizing a revised definition of caregiver to be “an adult family member or other individual who has a significant relationship with, and who provides a broad range of assistance to, an individual with a chronic or other health condition, disability, or functional limitation” and “a family member, friend, or neighbor who provides unpaid assistance to a person with a chronic illness or disabling condition.”
Codes 97550 and 97551 are used to report the total duration of face-to-face time spent by a qualified healthcare professional providing training to the caregiver(s) of an individual patient without the patient present.
Code 97552 is used to report group caregiver training provided to multiple sets of caregivers for multiple patients with similar conditions or therapeutic needs without the patient present.
Code and Full Code Descriptions
- 97550 Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; initial 30 minutes.
- 97551; each additional 15 minutes (List separately in addition to code for primary service)
- 97552 Group caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face with multiple sets of caregivers.
Documentation
- All codes must include:
- Caregiver identification
- Content of training
- CPT 97550 and 97552
- These are time-based codes; therefore, time must be documented in the medical record in addition to the above.
Please refer to your local payer guidelines and/or MAC to ensure compliance with all requirements.
Resources
- CMS 2024 Physician Fee Schedule Final Rule
- 2024 CPT Book
