98960

What are the documentation requirements to bill for a 98960?

Thanks

re: 98960

This code,
Education and training for patient self-management by a qualified, non-physician health care professional using a standardized curriculum, face-to-face with patient (could include caregiver/family) each 30 minutes; individual patient

is not a covered code by Medicare. check with your other payers for coverage.

Having said that, it is time based code, so document time. Document the standardized curriculum used. Who was in the room, the nature of the counseling and who provided it.

CPT® uses the words "qualified non-physician health care professional." check with payers.

For Medicare, it has a status indicator of B: bundled. No separate payment.