WOCN Asks CMS to Clarify New Caregiver Codes

Starting in 2024 Medicare will pay for caregiver training services for caregivers involved in the treatment of Medicare patients, known as Caregiver Training Services (CTS). The education will be covered if both of these conditions apply:

• The training focuses on helping the patient meet the health and treatment goals they set with their doctor or other health care provider.
• The patient needs a caregiver’s help for their treatment to succeed.

If the patient’s healthcare provider determines that caregiver training is appropriate for the patient’s treatment plan, the caregiver can get individual or group training sessions from the provider without the patient present.

However, it was not entirely what conditions would be covered by the new codes, who could furnish the CTS, and to what settings the CTS would apply. In response to their questions from WOCN and other groups, CMS has created new education materials that are available to providers and facilities. This includes this new FAQ document (attached). Based on the responses from CMS we believe that ostomy education would be a covered condition and that the code can be applied across multiple settings. Below is a description of each code:

• 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 [ADLs], instrumental ADLs [IADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face-to-face; initial 30 minutes.
• 97551 – 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; each additional 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 [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.