After years of pressure from patient advocacy groups, Medicare will now reimburse primary care doctors for the time it takes to test elderly patients with cognitive impairment such as Alzheimer’s disease or dementia, at any stage, and offer information about care planning. Testing for Alzheimer’s disease can involve taking a thorough medical history, testing a patent’s mental status, doing a comprehensive physical and neurological exam, and conducting blood tests and brain imaging. Until now there was no specific Medicare reimbursement for dementia testing so many people went undiagnosed and treated until much later in their disease. Now doctors can bill Medicare with billing code G0505 for these services. Keep in mind that while Medicare will now pay for dementia testing and care planning, Medicare still does not pay for long-term custodial care services for Alzheimer’s patients.
According to the Alzheimer’s Association more than 5 million Americans are living with Alzheimer’s, and as many as 16 million will have the disease in 2050. But many patients may not know they have it: the association estimates only about 50 percent of Americans are being diagnosed. This new Medicare billing code will provide more incentive to primary care doctors to take the time for more evaluation and care-coordination. Early diagnosis and care planning is critical for best patient and caregiver outcome.