Over the course of the past two years, NCHEC has been in attendance at the American Medical Association (AMA) CPT® Editorial Panel meetings to learn more about the process of CPT coding. The Current Procedural Terminology (CPT) code set is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations. The CPT® Editorial Panel is responsible for maintaining this CPT code set. The panel is authorized by the AMA Board of Trustees to revise, update, or modify CPT codes, descriptors, rules and guidelines. On July 1, 2019 the American Medical Association (AMA) announced the approval of three distinct “Category III” codes for “Health and Well-Being Coaching.” The coach is defined as a non-physician health care professional certified by the National Board for Health and Wellness Coaching OR the National Commission for Health Education Credentialing, Inc. The Category III code will go into effect January 2020.
To clarify, CPT is divided into three categories of codes:
- Category I: Procedures that are consistent with contemporary medical practice and are widely performed.
- Category II: Supplementary tracking codes that can be used for performance measures.
- Category III: Temporary codes for emerging technology, services and procedures and service paradigms.
NCHEC’s Executive Director, Linda Lysoby, had the opportunity to provide input to presenters at the May 2019 CPT® Editorial Panel meeting in Chicago that supported the inclusion of those that are certified by NCHEC to be recognized in the new Category III CPT code. The following document provided by the AMA further explains the new codes and can be accessed: https://www.ama-assn.org/system/files/2019-06/cpt-category3-codes-long-descriptors.pdf. The description of Health and Well-Being coaching codes is at the end – page 15/16.
“I am very pleased with this new procedure code including our NCHEC-certified individuals to help showcase the important role of CHES® and MCHES® in the primary care setting,” said Lysoby. “While Category III codes are temporary procedures, they lay the foundation for data collection for future consideration for Category II and Category I codes, which are recognized for widespread reimbursement. It is my hope that this will open doors and create more opportunities for CHES® and MCHES® in primary care settings in the future. We will continue to support and represent our CHES® and MCHES® in this endeavor.”
Stay tuned: NCHEC is collaborating with leading organizations to develop and communicate a strategy to utilize the new CPT codes. More information will be available on the NCHEC Website in the near future. Thank you for your patience and continued support as the health education and promotion profession continues to advance.