Billing and Coding: Cognitive Assessment and Care Plan Service

CPT 99483 is payable for Medicare beneficiaries identified as cognitively impaired (including Alzheimer’s disease, other dementias, mild cognitive impairment, or clinician-determined impairment) when a comprehensive cognition-focused evaluation results in a written care plan and all required elements are completed. Coverage requires documentation of standardized validated assessment tools (with raw scores available), an independent historian for dementia staging, moderate-to-high medical decision making, medication reconciliation, safety and neuropsychiatric evaluation, caregiver identification, and that the written care plan was shared with the patient/caregiver; if required elements are not performed, report the appropriate E/M code instead.

"CPT 99483 is covered for Medicare beneficiaries who are cognitively impaired, including those diagnosed with Alzheimer’s disease, other dementias, or mild cognitive impairment."