The 10 Most Underused Medicare Codes in Primary Care

Primary care physicians spend a lot of time doing work that doesn't show in claims: counseling, care coordination, postdischarge follow-up, behavioral health support.

Over the past decade, Medicare has created a series of Current Procedural Terminology) CPT and Healthcare Common Procedure Coding System (HCPCS) codes to pay for at least some of that effort.

On paper, these services are widely covered. In practice, they're often barely used.

Studies of “prevention and care coordination” codes — including depression screening, chronic care management, advance care planning and others — show that only a small fraction of eligible Medicare beneficiaries ever receive a billed service.

Cognitive assessment and care planning for patients with dementia, for example, reaches at most about 2.4% of traditional Medicare beneficiaries with an Alzheimer's disease diagnosis, according to a Government Accountability Office analysis.