New and Revised CPT Codes For 2018
The following are additions and deletions to speech-language pathology related Current Procedural Terminology (CPT) codes and modifiers, effective January 1, 2018.
New CPT Codes
The following new CPT code will replace current CPT code 97532 (cognitive skills development, each 15 minutes).
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
- This code is untimed and can only be billed once per day regardless of the length of the session.
- Medicare will not accept CPT code 97127 and is replacing it with its own 15-minute G-code, G0515, for cognitive therapy. See New Medicare G-code below for additional information.
- Check with non-Medicare payers regarding implementation of 97127. You should also make sure reimbursement rates are reflective of a session, and not 15 minute units.
- Contact firstname.lastname@example.org if you find a payer is incorrectly implementing 97127.
Deleted CPT Codes
97532 Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
Revised CPT Codes
No speech-language pathology codes have been revised for 2018.
New Medicare G-code for Cognitive Treatment
G0515 Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
- Medicare will not accept new CPT code 97127 (Cognitive function intervention). Medicare has created G0515 to report cognitive treatment instead.
- G0515 mirrors former CPT code 97532 and should be reported on the claim form exactly as 97532 would have been, and in 15-minute units.
- Like 97532, G0515 should not be billed with CPT code 92507 (speech, language, voice, communication treatment). Review Correct Coding Initiative (CCI) edits for more information on same-day billing of CPT codes.
- Non-Medicare payers (i.e., Medicaid, Medicare Advantage or Part C, and private health insurance) may choose to implement either G0515 or 97127. Check with each non-Medicare payer to verify which code they will implement for cognitive treatment.
- Contact email@example.com if you find that a payer is incorrectly implementing a new code for cognitive treatment.
See ASHA's 2018 Medicare Fee Schedule for SLPs, published in mid-November, for further details.