How is this code applied.

98960 - 98962 Education and Training for Patient Self-Management

Codes within this range are used to report education and training of a patient when prescribed by a physician but performed by a non-physician provider. Guidelines indicate that a standardized curriculum must be utilized and may be modified to meet individual patient needs.

The focus of the training should be to teach the patient how to effectively manage their clinical condition. It may also include a patient’s caregiver. The service can be provided to either a single patient (98960) or a group of patients (98961-98962).

And what is meant by a standardized curriculum. I have an idea, just seeking different opinions. I haven’t found anything concrete in regards to guidelines for this code.

Also are you seeing a lot of reimbursement for these services in regards to Medicare and PPO insurance.

97760 - 97762 Orthotic Management and Prosthetic Management

I know I just drop a lot of info on you right now, but hopefully you wouldn’t mind share your input.


Daniel, CPC