AMA Approves New Category III CPT Codes for Coaching

National Board for Health and Wellness Coaching and VA Collaborate on Rollout

The National Board for Health and Wellness Coaching (NBHWC), a nonprofit subsidiary of the National Board of Medical Examiners (NBME), announces the American Medical Association’s (AMA) approval of new Category III Current Procedural Terminology (CPT®) Codes for health and well-being coaching effective January 1, 2020.

NBHWC and the U.S. Department of Veterans Affairs (VA) successfully applied for the creation of these new tracking codes, utilizing the NBHWC standards. VA will be tracking the use of the coaching codes to evaluate the effectiveness of coaching as a part of the Department’s whole health system of care. This data could support Category I approval.

Professionals certified by NBHWC or NCHEC (The National Commission for Health Education Credentialing, Inc.) can use the new codes. Over the next few months, NBHWC and NCHEC will develop guidelines on use of the new codes for National Board Certified Health and Wellness Coaches (NBC-HWCs), Certified Health Education Specialists (CHES®) and Master Certified Health Education Specialist (MCHES®), physicians and other healthcare providers, healthcare systems, and payers.

NBHWC and VA anticipate the use of the codes will increase recognition of Health and Well-Being Coaching as a valuable service. VA will use the codes to track coaching services delivered by VA-trained “Whole Health” coaches who are National Board-Certified Health and Wellness Coaches. VA coaches are vital members of the health care team, helping veterans get healthier and better manage chronic issues such as diabetes, pain, and depression.

“The new codes reflect what research is demonstrating: coaches have expertise that helps patients step into more active roles in their own care. NBHWC is optimistic the new codes will increase utilization of this service and support needed reimbursement in the near future,” explains Ruth Wolever, Ph.D., and NBHWC board member. Wolever and VA physician Dr. Kavitha Reddy and her team shared a vision for advancing this work. Dr. Reddy led the application process for new CPT codes.

Well-trained and certified health and wellness coaches—with expertise in patient-empowering communication and behavior change—engage patients to develop and implement a personal vision and plan for optimal health. With the coach’s support, patients cultivate the internal motivation, confidence, and resources needed to start and sustain behaviors shown to prevent or treat chronic disease and improve health and well-being.

Health care professionals are required to meet unified training and education standards and complete national examinations (that typically support state licenses) to be eligible to deliver healthcare services using CPT codes. In the absence of state licensure, NBHWC and NCHEC have, on behalf of their fields, developed independent national standards and certification for health and wellness coaches and health educators.

NBHWC and the NBME partnered to combine NBHWC coach training standards that emphasize live coaching skills training, mentoring, and skills assessment with NBME’s 100-year history of delivering medical licensing examinations.

The AMA defines a coach as a non-physician health care professional certified by NBHWC or NCHEC.

The approved Health and Well-Being Coaching Category III CPT® codes will be in effect for five years but are renewable. These temporary codes are intended to support the wide utilization and data collection, with and without reimbursement, required for AMA approval of Category 1 codes.Reimbursement by payers of Category III codes is optional starting January 1, 2020. Payers typically wait until codes have Category I approval to begin reimbursement.

The Category III Health and Well-Being Coaching Codes include:

• 0591T Health and Well-Being Coaching face-to-face; individual, initial assessment
• 0592T individual, follow-up session, at least 30 minutes
• 0593T group (two or more individuals), at least 30 minutesAbout the National Board for Health & Wellness Coaching (NBHWC)