New HCPCS Codes for Caregiver Training

New HCPCS codes in 2025 for caregiver training (HCPCS codes G0541–G0543).  

G0541

Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face; initial 30 minutes. 

G0542

Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service) (use G0542 in conjunction with G0541). 

G0543

Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face with multiple sets of caregivers 

In the Medicare physician fee schedule final rule for 2025, CMS approved three new HCPCS codes for caregiver training for direct care services and support. The topics of training could include, but would not be limited to, techniques to prevent decubitus ulcer formation, wound dressing changes, and infection control.  

These new caregiver training services (CTS) codes for direct care services and support focus on specific clinical skills aimed at the caregiver using hands-on treatment, reducing complications, and monitoring the patient.  

For example, in the direct care CTS codes, a caregiver could be taught how to properly change wound dressings to promote healing and prevent infection. This skill, among other direct care services, would not fall into the categories of CTS codes that currently exist (behavior management/modification or strategies and techniques to facilitate the patient’s functional performance in the home or community), but is integral in affecting the patient’s treatment plan.  

Like other codes describing caregiver training services, these new codes would reflect the training furnished to a caregiver, in connection with the diagnostic and treatment services furnished directly to the patient, in activities to help the patient to carry out the treatment plan. CMS believes that CTS may be reasonable and necessary when they are integral to a patient’s overall treatment and furnished after the treatment plan is established.  

The CTS themselves need to be consistent with the treatment plan and designed to affect the desired patient outcomes. CMS believes this is especially the case in medical treatment scenarios where assistance by the caregiver receiving the CTS is necessary to ensure a successful treatment outcome for the patient, for example, when the patient cannot follow through with the treatment plan for themselves. 

Direct care training for caregivers of Medicare beneficiaries should be directly relevant to the person-centered treatment plan for the patient in order for the services to be considered reasonable and necessary under the Medicare program. Each training activity should be clearly identified and documented in the treatment plan. Additionally, this would not be billable for caregiver training that is already being separately billed for patients under home health plan of care, receiving at-home therapy, or receiving DME services for involved medical equipment and supplies. 

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