The following Current Procedural Terminology (CPT® American Medical Association) codes represent supportive or miscellaneous services that supplement or are adjunct to direct patient care. Supportive services, such as case management or patient education services, are designed to enhance or assist a patient with treatment goals or to monitor treatment effectiveness. Miscellaneous services generally provide a means to report the completion of special services that are adjunct to basic treatment and evaluation services, such as completing special reports or providing medical testimony. For virtual services, such as e-visits, virtual check-ins, telephone assessments, and remote monitoring, see ASHA's web page on communication technology-based services.
Medicare does not recognize these codes for billing by audiologists and speech-language pathologists (SLPs). However, other payers may elect to cover them. Before initiating services, always verify coverage directly with the payer and notify patients that they may be responsible for payment of non-covered services.
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See also: Virtual Services
Use these codes to report educational and training services to an individual or a group of patients for the purpose of teaching the patient(s) (including caregivers) how to self-manage their condition or disorder.
98960 Education and training for patient self-management by a qualified, nonphysician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient
98961 2–4 patients
98962 5–8 patients
You must meet the following criteria to report the education and training codes:
If you participate in medical team conferences for a patient's care, you may use medical team conference CPT codes to report 30 minute or longer meetings. These should be of special interest to those involved in cleft palate teams, feeding teams, or other medical teams. These codes may not be used to report conferences that are not medical or clinical in nature.
99366 Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more; participation by nonphysician qualified health care professional
(Team conference services of less than 30 minutes duration are not reported separately)
99368 Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional
(Team conference services of less than 30 minutes duration are not reported separately)
You must meet the following criteria to report the team conference codes:
Reporting participants should record their role in the conference, contributed information, and subsequent treatment recommendations. The time for the team conference starts at the beginning of the case review and ends at the conclusion of the review. Record keeping or report generation time is not included. However, the time is not limited to the time that the participant is addressing the team or patient/family.
Miscellaneous services generally provide a means to report the completion of special services that are adjunct to basic treatment and evaluation services, such as completing special reports, providing educational materials, or providing medical testimony. Most payers do not recognize these services for billing, unless specifically indicated in coverage policies. For example, supplies and materials are typically bundled with the service/procedure and are not separately payable. In addition, your contract with payers may prohibit you from directly billing patients for these services. Please check with payers regarding coverage of these services.
99056 Service(s) typically provided in the office, provided out of the office at request of patient, in addition to basic service
99070 Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided) (For additional supplies, materials, and clinical staff time required during a Public Health Emergency, as defined by law, due to respiratory-transmitted infectious disease, use 99072)
99071 Educational supplies, such as books, tapes, and pamphlets, for the patient’s education at cost to physician or other qualified health care professional
99072 Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency, as defined by law, due to respiratory-transmitted infectious disease
99075 Medical testimony
99080 Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form (Do not report 99080 in conjunction with 99455, 99456 for the completion of Workmen’s Compensation forms)
You must meet the following criteria to report the miscellaneous services codes: