Caregiver Training Codes

Over 53 million people in the U.S. provide unpaid caregiving services. That's a stunning 1 in 6 people.

The complex role of caregiving can entail everything from behavior management, symptom detection, and nutritional guidance to medication administration and transfer skills.

As you can imagine, insufficient caregiver training can lead to increased patient risks for safety and injury, worsening symptoms, loss of function, and higher healthcare utilization costs.

And for the caregivers themselves—unmet training needs are associated with higher anxiety, depression, burden, and lower self-esteem.

Prior to 2024, healthcare workers like OTs and PTs faced significant billing barriers because insurance required the patient to be present and actively participating during training. But in 2024, new Caregiver Training Service codes were introduced that every OT and PT needs to understand.

In this course, we'll look at these codes with dementia expert Rachel Wiley. We'll talk about what they entail, with a focus on how they can be implemented in practice. But we will also talk about their current limitations—and future directions for truly meeting the massive needs of caregivers and their patients.

CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved. CPT® code descriptions and functional billing parameters presented in this course are adapted from public domain federal rulemaking published by the Centers for Medicare & Medicaid Services (CMS) in the CY 2024 Medicare Physician Fee Schedule Final Rule (CMS-1784-F).

Quick Guide to Caregiver Codes

Code 97550 (~$50.61): Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (e.g., activities of daily living [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face; initial 30 minutes.

Code 97551 (~$25.30): Each additional 15 minutes (List separately in addition to code for primary service) (Use 97551 in conjunction with 97550).

Code 97552 (~$22.00): 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 [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face with multiple sets of caregivers.

Source: Functional code descriptions adapted from the public domain federal rulemaking in the Centers for Medicare & Medicaid Services (CMS) CY 2024 Medicare Physician Fee Schedule Final Rule (CMS-1784-F). Estimated rates reflect national average unadjusted Medicare Physician Fee Schedule (MPFS) reimbursement amounts. CPT® is a registered trademark of the American Medical Association.

1. You will be able to identify options for assessing the needs of the caregivers prior to training.

2. You will be able recognize best practices for providing caregiver training, per the latest research.

Intro (5 minutes)

Discussion (40 minutes)

1. Rachel, you’ve dedicated your career to helping patients with complex care needs- tell me a little bit about that journey and the challenges you’ve encountered.

2. What are the new caregiving codes - and how are they one step towards meeting complex care needs?

3. What reaction have you heard on the ground?

4. What could it look like to implement these new codes, and what are the limitations?

5. From your experience, what are options for assessing the needs of caregivers- what does this look like in practice?

6. What can caregiver training look like in practice? (and what do we know about best practices?)

7. What further training is available for therapists who are interested in skilling up in caregiver support?

8. If you could modify these caregiver training codes for the future, what would you do?

9. Caregiver training is only one part of helping us care for complex patients- what changes would you like to see in our healthcare system overall to help us meet the needs of complex patients?

Live Q&A (5-10 minutes)

Closing (5 minutes)

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• Systematic Review of the Evidence for Stroke Family Caregiver and Dyad Interventions

• Early Use and Impact of Medicare Caregiver Training Services

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We here at OT Potential have no financial stake in this topic.