Medicare checkup: Care planning covered for persons with cognitive impairment

Pamela J. Myers, Alzheimer’s Association NW and Central Ohio

        With 2022 Medicare Open Enrollment period coming up, it is a good time to do a “Medicare Check Up” to review Medicare basics and your coverage options.
        Care and treatment of a person with cognitive impairment can be very costly – so here is an important covered benefit that anyone caring for a person with cognitive impairment should be aware of.
        At the Alzheimer’s Association, we know that only 33% of seniors with Alzheimer’s disease are aware of their diagnosis. Studies have found one of the reasons physicians do not diagnose Alzheimer’s – or do not disclose a diagnosis once it is made – is because of their lack of time and resources to provide care planning.
        • What is care planning? Care planning provides individuals diagnosed with cognitive impairment and their caregivers with information about medical and non-medical treatments, clinical trials and support services available in the community – all of which can contribute to a higher quality of life.
        People who receive proper care planning are shown to have fewer hospitalizations and emergency room visits, and
better medication management. In addition, because dementia can complicate the management of other chronic conditions, care planning is key to coordinating a person’s overall care.
        • Does Medicare cover care planning? Effective Jan. 1, 2017, individuals with cognitive impairment have access to care planning with a medical professional through Medicare. Clinicians such as physicians and nurse practitioners/clinical nurse specialists who treat Medicare beneficiaries with cognitive impairment, including Alzheimer’s disease and other dementias, are eligible for reimbursement under Medicare using the CPT code 99483.
        • What will the assessment address? The 99483 code requires clinicians to provide detailed, person-centered care planning that includes several areas: evaluating cognition and function; measuring neuropsychiatric symptoms; medication reconciliation; evaluating safety (including driving ability); identifying caregivers and caregiver needs; identifying and assessing care directives; and referrals to community services for both the beneficiary and his or her caregiver.
        Discuss care planning and the 99483 code with your health care provider the next time you visit or at your annual checkup.
        Call the Alzheimer’s Association at 800-272-3900 or visit to learn more.


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