New Coding For Educational Services

You may already be tearing your hair out trying to keep up with the ever-changing CPT codings and relearning the newly changed codes on your superbill. There were also 3 low-key series additions that describe educational services that you may provide.

Education and Training For Patient Self Management includes the following codes:
* 98960–Education and training for patient self-management by a qualified, nonphysician healthcare professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient.

* 98961–… 2-4 patients

* 98962–… 5-8 patients.

Reserve Self-Management for Non-MD Education is another set that was added and includes the range of codes from (96150-96155). Only non-physicians will use these codings.

There are certain requirements for reporting these codings. The physician must prescribe the education and training in writing. A qualified healthcare professional must provide the information using a standardized curriculum. If the educational information is imparted by a non-physician, the program’s contents “must be consistent with guidelines or standards established or recognized by a physician society, nonphysician healthcare professional society/association, or other appropriate source,” according to CPT’s introductory patient self-management education and training notes.

Asthmatics and Diabetics who need education on day to day living with their disease are prime candidates for educational services. If you have a patient that is in enrolled in an ongoing disease management program, you can also utilize these education codes.

View all Articles by: Melissa Clark, CCS-P