Please note that this article contains information that is only relevant to American clinics.
It’s like they say: new year, new CPT codes. Well, we’re not sure if that’s actually something that they say—but it very well could be—because with each new year, we’re given a handful of changes to our list of CPT codes. And in 2019, some CPT codes have been deleted, and some new ones have been added. So the goal of this article is to provide an update on the changes to CPT codes.
The CMS has removed two CPT codes that may affect PTs, OTs, and SLPs. The first of which is CPT 64550 (application of surface neurostimulator). The second CPT code that was removed is CPT 96111 (developmental testing with interpretation and report).
The removal of the second code is a rather impactful change, since it covers assessments of motor, language, social adaptive, and cognitive functioning by standardized instruments. However, there is a new CPT code being introduced in 219 that speaks to this.
With the removal of two CPT codes for 2019, the CMS has opted to add two new ones for use by PTs, OTs, and SLPs. CPT 96112 (Developmental test administration by physician or other qualified healthcare professional, with interpretation and report; first hour) was added to replace 96111. They also added CPT 96113 to indicate each additional 30 minutes spent performing the activities described in 96112.
When it comes to the specific activities described in 96112, they’re largely similar to 96111. However, 96112 has been expanded to include memory and executive functions.