G0540, Caregiver training in behavior management/modification for
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.54
Facility
$21.04
Non-Facility
$26.05
Documentation Required
- Required documentation (medical records, evidence of skilled need, teaching/training plans, and physician orders) and any specific forms or certifications are those specified in LCD L34562 and applicable payer guidance.
Key Coverage Criteria
- Skilled nursing teaching and training services for beneficiaries diagnosed with Alzheimer's disease or related behavioral disturbances when the services meet the coverage criteria in LCD L34562.
1 Active Policy
A56641, Billing and Coding: Home Health Skilled Nursing Care-Teaching and Training: Alzheimer's Disease and Behavioral Disturbances
Related Codes
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