Updates to the list of codes that sometimes or always describe therapy services under Medicare Part B go into effect Jan. 1, 2020. Make sure your coding and billing staff are aware of the following updates impacting coding for physical therapy, occupational therapy, and speech-language pathology service claims.
Two new biofeedback training CPT® codes 90912 and 90913 are added:
90912 Biofeedback training, perineal muscles, anorectal or urethral sphincter, including electromyography (EMG) and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient
90913 ; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (List separately in addition to code for primary procedure)
These two codes replace 90911.
Cognitive Function Coding
Two new cognitive function CPT® codes 97129 and 97130 were added to replace 97127, which Medicare did not recognize. These new codes will replace HCPCS Level II code G0515, which will be deleted, effective Jan. 1, 2020.
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
97130 ; each additional 15 minutes (List separately in addition to code for primary procedure)
Additional Therapy Services Updates
For CY 2020, four manual muscle testing codes were deleted: 95831, 95832, 95833, and 95834.
Additionally, 42 HCPCS Level II G-codes related to the discontinued functional reporting of therapy service requirement are deleted for dates of service after Dec. 31, 2019: HCPCS Level II codes G8978 through G8999, G9158 through G9176, and G9186.
For more information, see MLN Matters article 11501.