Effective for 2020, psychologists need to use two new CPT® codes for reporting cognitive function intervention services.
As part of their annual update to coding and payment policies, the Centers for Medicare and Medicaid Services (CMS) eliminated the previous service code (97127) and replaced it with the two new codes which should be reported using the modernized base/add-on coding structure:
- 97129: 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; initial 15 minutes.
o Work RVU: 0.50
- +97130: 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; each additional 15 minutes (List separately in addition to code for primary procedure).
o Work RVU: 0.48
+ indicates an add-on code
The new base/add-on code pair for reporting cognitive function was created because this service has changed from an untimed to a timed-based service. Psychologists must now use the stand-alone base code, 97129, to report the first 15 minutes of performing the primary service, and a 15-minute add-on code, 97130, which can be reported in multiple units, to report additional time (beyond the initial 30 minutes) required to complete the overall service.
CMS’ approval of the 2020 CPT codes for cognitive function intervention also means that G0515 — a code in the Healthcare Common Procedure Coding System used for reporting cognitive skills development services provided to Medicare beneficiaries — will be deleted. Therefore, effective Jan. 1, 2020, CPT codes 97129/+97130 should be used when billing both commercial and federal insurers.