What is a cognitive assessment and care plan visit?

Cognitive assessment and care plan services are a separate Medicare-covered visit to fully review a person's memory and thinking, confirm a diagnosis such as dementia or Alzheimer's, and build a care plan. Medicare.gov says the provider may examine the person, review medications, identify caregiver support, help with advance care planning, refer to specialists, and point the family to community resources such as adult day programs and support groups.

Yes. Medicare Part B covers a separate visit for a cognitive assessment and care plan, and after the Part B deductible you pay 20% of the Medicare-approved amount. Medicare.gov adds that a provider may also check for signs of dementia during other visits, including the yearly Wellness visit. You can bring a spouse, friend or caregiver along to help listen to information and answer questions.

CPT code 99483 is the billing code for Medicare's cognitive assessment and care plan visit, used for people with any cognitive impairment, including dementia and Alzheimer's, at any stage. CMS says an independent historian, such as a spouse or other family member, must be present for the visit to be billed. It can be billed separately from the yearly Wellness visit, and Part B coinsurance and deductible apply.

In Medicare's cognitive assessment and care plan visit, CMS says the clinician examines cognition, reviews history and records, assesses daily activities and decision-making, stages the dementia with standard tools, reviews high-risk medications, screens for depression, anxiety and behavior symptoms, checks home and driving safety, and asks what caregivers can provide. The result is a written care plan with referrals to community resources.

A full cognitive assessment and care plan visit typically takes about 60 minutes face to face, according to CMS, and providers can bill extra time when it runs longer. Brief screening tests are much shorter: the Alzheimer's Association notes that the screening tools it recommends for primary care take five minutes or less. A short screen only flags who needs the fuller evaluation.