Medicare Adopts New Codes & Payment For Caregiver Training For Direct Care Services
Under the 2025 Medicare Physician Fee Schedule (PFS), the Centers for Medicare & Medicaid Services will start covering costs of caregiver training for direct care services and support. The covered training will focus on preventing pressure ulcers, wound care, and infection control. CMS also plans to establish new coding and payment for caregiver behavior management and modification training that can be furnished to a beneficiary’s caregiver(s).
The caregiver training services will be eligible to be provided via telehealth on a provisional basis. The PFS for 2025 adds the following codes to cover caregiver training services: CPT codes 97550, 97551, 97552, 96202, 96203 and HCPCS codes G0541-G0543 (GCTD1-3) and G0539-G0540 (GCTB1-2). The new coding and payment for the training will be effective on or after January 1, 2025.
The annual PFS makes a variety of updates to Medicare fee-for-service physician payment under Part B and other services covered by Part B. Overall, physician payment rates will be cut by 2.83%.
In addition to the caregiver training services, other services were added to the Medicare Telehealth Services List. PrEP counseling and safety planning interventions were permanently added to the list. CMS will continue to suspend previous frequency limitations for subsequent inpatient visits, subsequent nursing facility visits, and critical care consultations. Additionally, the PFS finalizes a policy to allow two-way, real-time, audio-only communications for any Medicare telehealth service furnished to a beneficiary in their home if the remote physician or clinical professional is techically able to use an interactive telecommunications sytem, but the beneficiary is not capable of, or does not consent to, the use of video technology.
A link to the full text of “Medicare and Medicaid Programs: Calendar Year 2025 Payment Policies under the Physician Fee Schedule” is in the OPEN MINDS Circle Library at https://openminds.com/market-intelligence/resources/120924physicianfeesched/.
For more information, contact:
- Sarah Leipnik, 2025 CY PFS Contact Point for issues related to caregiver training services, U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244; 410-786-3933; Email: MedicarePhysicianFeeSchedule@cms.hhs.gov; Website: https://www.cms.gov/
- Mikayla Murphy, 2025 CY PFS Contact Point for issues related to caregiver training services, U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244; 667-414-0093; Email: MedicarePhysicianFeeSchedule@cms.hhs.gov; Website: https://www.cms.gov/
- Regina Walker-Wren, 2025 CY PFS Contact Point for issues related to caregiver training services, U.S. Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244; 410-786-9160; Email: MedicarePhysicianFeeSchedule@cms.hhs.gov; Website: https://www.cms.gov/
