If you’re looking for a list of 2020 CPT code changes, look no further. Here, we review the updates you’ll want to know about in the coming year.
But because we love saving you time, we won’t make you scroll through the entire post to find the current procedural code changes that apply to your practice. To jump ahead to the sections that are of most interest to you, simply click on these links:
List of 2020 CPT Code Changes:
- Evaluation and Management
- Physical Therapy
- Health / Behavior Intervention
- Pain Management
Our list is not exhaustive, but our goal is to streamline the information, making the changes a bit easier to understand and implement.
Note: When it comes to CPT code changes, there’s a fine line between the right amount of info and waaaay too much detail. In most cases, we’ve opted for a less-is-more approach. So if one of the changes sparks questions for you, please don’t hesitate to get in touch, and we’ll be happy to provide you with more detail.
Update Patient Info: Especially Important in 2020
Of course, it’s always good practice to update patient information on an annual basis. And the start of the year is a great time to kick this effort off.
But in 2020, this step will be more important than ever. Although in the past, Medicare has processed with either old IDs or the new Medicare Beneficiary IDs (MBIs), beginning on January 1st of 2020, they will not process claims without those new MBIs.
A Look Ahead to Future CPT Code Changes
A year from now, we will be preparing for some very significant changes from the American Medical Association (AMA). So let’s take a quick look ahead to the big CPT code changes slated to take effect in 2021:
First, coding will either be based on time or on medical decision making.
This represents one of the most significant changes in documentation and coding since the release of the documentation guidelines in 1995. It comes in response to the Centers for Medicare & Medicaid Services requesting a change in office-visit coding, in order to reduce providers’ administrative burden.
Over the coming year, we expect the AMA to provide additional guidance and training in this area, helping providers prepare before the change takes place.
In addition to the big coding change, we also expect to see significant increases to allowed amounts for evaluation and management services. So there’s a lot on the horizon to keep in mind.
List of 2020 CPT Code Changes
Evaluation & Management
The evaluation and management category has a number of 2020 CPT code changes, some small and some large. Let’s start with the little guys:
99473 & 99474
Blood pressure codes for use when patient is self-reporting.
Patient education/training and device calibration.
Review of self-reported measurement with report and treatment plan.
99421 – 99423
For online E/M services, code 99444 has been deleted and updated to a larger range of codes numbered 99421 – 99423, based on time.
Providers are to communicate with patients via EHR portals or secure e-mail.
G2064 & G2065
Principal care-management codes created, similar to the CCCM codes. But these are for use with single high-risk disease codes.
Must have at least 30 minutes per month in management.
G2086, G2087, & G2088
New codes for office-based Opioid Use Disorder Treatment.
Just a few 2020 CPT code changes to list for physical therapy:
- New modifier must be used for services rendered in whole or in part by a physical therapy assistant. Modifier for physical therapy assistants is CQ and it must be on these services starting Jan 1st, 2020.
- No payment adjustment for 2020. But starting on Jan 1st, 2022, Medicare will allow an assistant 85% of what they allow for a physical therapist.
Health / Behavior Intervention
In health / behavior intervention, the AMA has replaced 6 previous codes for health behavior assessment and intervention with 9 codes.
- Assessment (96150) and reassessment (96151) used to have separate codes, but now they are combined under 96156, and time does not factor.
- Addition of codes 96158, 96164, and 96168 for 30 minutes. In the past, all codes were per 15-minute interval. But with these changes, the initial visit is now 30 minutes, and over 30 minutes bills at 15-minute intervals with codes 96159, 96165, and 96168.
The AMA has made some changes to long-term EEG monitoring, including:
- Deletion of codes 95827, 95950, 95951, 95953, 95956
- Addition of codes 95700 – 95726, with new codes broken down by time, whether or not video recording is used, as well as technical and professional component
The AMA has made a number of 2020 CPT code changes in the ophthalmology category, including:
- Revision of current codes 66982 and 66984, noting without endoscopic cyclophotocoagulation.
- Addition of codes 66987 & 66988, to mirror 66982 (66987) and 66984 (66988) with cyclophotocoagulation.
- Used to be initial or subsequent. Now based on what part of the eye. These codes include unilateral or bilateral and can only be 1 unit, with no additional reimbursement regardless of whether the procedure is unilateral or bilateral.
- Deletion of codes 92225 & 92226, now codes 92201 & 92202.
In pain management, the biggest 2020 CPT code changes relate to somatic nerve injections.
Changes to parentheticals on Facets:
- Initial codes (64490 & 64493, 64633, 64635) can be reported bilaterally with modifier 50, but additional levels (64491, 64492, 64494 and 64495, 64634, 64636) are not to be billed bilaterally with modifier 50. Instead, they are x 2 units.
New CPT codes:
- 64451: injection into nerves innervating the SI joint, with imaging guidance
- 64454: injection into genicular nerve branches, including imaging guidance (when all of these 3 branches injected: superolateral, superomedial, and inferomedial)
- 64624: destruction, by neurolytic agent, of the 3 genicular nerve branches (if all 3 are not done, report with modifier 52), with imaging guidance
- 64625: RF ablation of nerves innervating the SI joint, with imaging guidance
Some deletions for procedures rarely done:
Whew! That was a lot of information.
Did you walk away with questions? If so, please get in touch, and one of experts will dig into the nitty gritty with you.