cpt 98960, cpt code 98960, 98960 cpt code

CPT 98960 | Education & Training For Patient Self-Management

CPT code 98960 is used for billing education and training a non-physician healthcare professional provides to self-manage an established illness or disease to increase the patient’s self-efficacy and self-management behaviors.

What Is CPT Code 98960?

CPT 98960 describes a procedure in which a non-physician healthcare professional provides education and training to a patient for self-management of an established illness or disease.

The training involves face-to-face interaction with the patient, may include a caregiver or family member and is provided using a standardized curriculum modified as necessary for the patient’s specific health condition and circumstances.

The training aims to educate and empower patients, increasing their self-efficacy and self-management behaviors.

Description

The CPT book describes CPT code 98960 as: “Education and training for patient self-management by a qualified, non-physician health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) every 30 minutes; individual patient.”

Procedure

The approach of self–management support programs depends on the patient’s condition.

The interaction between the patient and the healthcare professional includes a vital element of coaching to educate and empower the patient and increase their self–efficacy or self–management behaviors.

Healthcare professionals usually provide training using a standardized curriculum to an individual patient to treat an established illness or disease or delay comorbidity.

The healthcare professional modifies this curriculum as necessary for the patient’s specific health condition and circumstances.

How To Use CPT 98960

CPT code 98960 is typically used for treatment or to delay comorbidity.

Qualified, non-physician healthcare professionals usually include;

  • physician assistants or PAs;
  •  nurses;
  •  physical therapists;
  •  trained social workers;
  •  nurse practitioners or NPs;
  •  respiratory therapists; and
  •  similar medical professionals instead of physician providers.

Report CPT code 98961 instead of CPT 98960 for the same procedure involving two to four patients and CPT 98962 for a group of five to eight patients.

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