1.9.2023 Board Book

III. Rationale/Code descriptor III. 1 Rationale for Code Change

Indicate the specific reasons why this code change is necessary (rationale). For example, "This is a new procedure, not described in CPT". Avoid non-rationales. Reasons like "no code currently available" or "need new code" do not describe the clinical reason for which you are requesting a coding revision.

Our Rationale for Code Change Our team of co-applicants proposes approval of Category I status of the Category III codes for health and well-being coaching services. These codes were approved in May 2019, and further modifications to the code description were approved in September 2021. The co-applicants represent: 1. Qualified coaching providers - NBHWC, NCHEC, and AHNCC 2. Healthcare systems - Veteran’s Health Administration (VHA), Mayo Clinic, Massachusetts General Hospital) 3. Medical societies - Obesity Medicine Association, American College of Preventive Medicine, American College of Sports Medicine, and American College of Lifestyle Medicine Appendix A lists the 65 healthcare organizations (and 250+ locations) which contributed data to the utilzation summary in Section V-2. Our rationale is summarized: A. Utilization volume is high and growing Based on our nationwide outreach since 2021, we estimate that the volume of health and well-being coaching services adds up to more than four million coaching visits: 1. reported in the literature in the treatment of chronic diseases (53 large studies since 2000), 2. reported by 56 healthcare organizations with permission to share their data (2015 2022),

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Code Change Application-last updated Dec 29,2022 CPT is a registered trademark of the American Medical Association Copyright 2013-2021 American Medical Association. All rights reserved.