Medicare Now to Reimburse Doctors for Testing Patients for Alzheimer’s or Dementia

By Stephen J. Silverberg
New York Elder Law Attorney

Once a person hits the age of 65 or 70, primary care doctors should be doing screening tests on a regular basis, either annually or at least every couple of years.

Finally, after many years of pressure from patient advocate groups, Medicare will reimburse doctors for the time needed to test patients with cognitive impairments and offer information about care planning.

Many would think primary care physicians are already doing this, but that’s not always so.

Santa Cruz Sentinel’s recent article, “Diagnosing Alzheimer’s: Medicare now pays doctors to stop and assess memory loss,” reports that over 5 million Americans are living with Alzheimer’s, and 16 million will have the disease in 2050. The cost of caring for those with the disease and other types of dementia is skyrocketing. In the U.S., it’s estimated to total $236 billion in 2016 and is anticipated to increase to $1.1 trillion by 2050.

However, many people are unaware that they are afflicted with the disease: only about 50% of Americans are diagnosed. Experts contend that many doctors don’t take the time required to test for Alzheimer’s disease.  However, the new Medicare billing code will provide more incentive for primary care doctors to take the time for more evaluation and care-coordination.

An early and documented diagnosis—with access to care planning services—gives Alzheimer’s patients better outcomes. It’s even possible to see signs of cognitive problems before the person realizes it themselves. However, research suggests that medications will only be effective in the early stages of the disease, when the symptoms are the mildest. Therefore, primary care doctors must look for those mild cognitive problems.

 However, many physicians aren’t equipped to help their patients take advantage of the new Medicare rule. The issue is that more front-line physicians typically aren’t trained. They first must understand how to assess these patients before referring them to neurologists or to develop care plans.

Many groups are stepping forward to help educate family physicians about Medicare’s new coverage to support them in providing this care.

About the Author
Stephen J. Silverberg is nationally recognized as a leader in the areas of estate planning, estate administration, asset preservation planning, and elder law. He is a past president of the prestigious National Academy of Elder Law Attorneys (NAELA), and a founding member and past president of the New York State chapter of NAELA.