2025 Caregiver Training Begins: Key Points About Home Care’s Role

Starting in 2025, Medicare will enhance support for family caregivers by reimbursing caregiver training services through newly introduced CPT and HCPCS codes in the Medicare Physician Fee Schedule. This crucial initiative empowers caregivers to effectively manage the complex needs of individuals with chronic conditions, disabilities, or functional limitations, ensuring a higher quality of care for those who depend on them. Key Points for Home Care Providers Covered Training Areas Topics include managing activities of daily living, wound care, pressure ulcer prevention, infection control, transfers, mobility, communication, feeding, and safety practices. Behavioral management training for caregivers will also be supported. Billing Codes CPT codes 97550, 97551, and 97552 are designated for caregiver training delivered in person, without the patient present. They cover both individual and group sessions. HCPCS codes (G0541–G0543 and G0539–G0540) address broader caregiver training services, potentially including telehealth delivery. Provider Eligibility Physical therapists, occupational therapists, speech-language pathologists, and other healthcare professionals can bill for these services under specific conditions. Services must align with an established care plan. Telehealth and Access While most codes currently require in-person delivery, some may be provided via telehealth. This flexibility is meant to improve access for caregivers in underserved areas. Reimbursement Rates Medicare has assigned national payment amounts, which vary based on locality. Providers should verify with their Medicare Administrative Contractor or private payers for exact rates. Examples of How Coding Works It is important to note that the CPT codes are broken down into appropriate group codes or individual codes based on the number of patients represented for caregiver training. For example: If the clinician is working with a patient’s daughter who is providing in-home support to her father with dementia, and the clinician and the daughter discuss the diagnosis and regularly review care plan needs and medication concerns to support the patient’s health condition, then CPT codes 97550 would be appropriate. However, if the clinician is hosting a dementia education and support group with caregivers, the code would be 96202. If multiple caregivers are present for the same patient in the group setting, the time is still the same for the individual patient. Thus, the codes are based on training time related to the patient, not the number of caregivers. An Overview of Codes Code Definition Participants Service Time 96202 Multiple-family group behavior management/ modification training for parent(s)/guardian(s)/ caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of parent(s)/guardian(s)/ caregiver(s); initial 60 minutes Behavior management/ modification training Multiple sets of caregivers (regarding different patients) Entire 60 minutes 96203 Each additional 15 minutes Behavior management/ modification training Multiple sets of caregivers (regarding different patients) Entire 15 minutes 97550 (Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (e.g., activities of daily living, instrumental activities of daily living, transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face; initial 30 minutes), Functional performance of activities of daily living One or more caregiver (s) for a single patient Entire 30 minutes 97551 Each additional 15 minutes Functional performance of activities of daily living One or more caregiver (s) for a single patient Entire 15 minutes 97552 (Group caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (e.g., activities of daily living, instrumental activities of daily living, transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face with multiple sets of caregivers). Functional performance of activities of daily living Multiple sets of caregivers (regarding different patients) Not timed. Implications For Home Care Providers This initiative emphasizes caregiver engagement as an essential component of home-based care, reducing hospital readmissions and improving patient outcomes. It’s important for providers to integrate these training sessions into care plans and document services to meet billing requirements. Additional Resources CMS Proposes Payment to Physicians to Train Caregivers Download ArticleDownload the Entire Issue

CIDR	Start of Range	End of Range
173.236.20.0/24	173.236.20.2	173.236.20.254
192.92.97.0/24	192.92.97.2	192.92.97.254
52.128.40.0/21	52.128.40.0	52.128.47.255

2025 Caregiver Training Begins: Key Points About Home Care’s Role

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