6 steps to reduce uncompensated time using new medical codes for caregiver training services

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More than one in five Americans are caregivers, having provided care to an adult or child with special needs at some time in the past 12 months. Caregiving can be overwhelming, especially in the beginning, as caregivers become accustomed to understanding expectations and establishing routines. Fortunately, with updates to the 2025 Medicare physician fee schedule final rule that took effect January 1, physicians can now bill and receive payment for caregiver training. [Learn more about additional 2025 updates here.] 

Caregiver training services in the 2025 Medicare physician fee schedule
If you plan to provide and bill for caregiver training services in your medical practice, here are six steps you’ll need to take:

1. Know what codes to report for caregiver training services. The 2025 Medicare physician fee schedule includes three new medical codes for caregiver training in direct care strategies and techniques and two new medical codes for caregiver training in behavior management/modification as follows:

• G0539: Caregiver training in behavior management/modification for caregiver(s) of a patient with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; initial 30 minutes. In the 2025 Medicare physician fee schedule, G0539 has a work relative value unit (wRVU) of 1.00.

• G0540: Caregiver training in behavior management/modification for caregiver(s) of a patient with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face; each additional 15 minutes (List separately in addition to code for primary service) (Use G0540 in conjunction with G0539). In the 2025 Medicare physician fee schedule, G0540 has a wRVU of 0.54.

• 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. In the 2025 Medicare physician fee schedule, G0541 has a wRVU of 1.00.

• 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). In the 2025 Medicare physician fee schedule, G0542 has a wRVU of 0.54.

• 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 2025 Medicare physician fee schedule, G0541 has a wRVU of 0.23.

2. Know when you are permitted to bill caregiver training services. Medicare Part B covers caregiver training services when a patient needs a caregiver’s help to carry out treatment and the training focuses on helping the patient meet treatment goals. For example, these services may include teaching the caregiver how to give medications, provide emotional support, move the patient safely, change a wound dressing, prepare a special diet, help with daily tasks, and more. Note that your medical practice may already provide these services and not bill for them. Moving forward, it will be important to recognize uncompensated time related to training caregivers and ensure more deliberate efforts to capture billable services. 

3. Plan to collect a patient copayment for caregiver training services. After patients meet their Medicare Part B deductible, they will pay 20% of the Medicare-approved amount each time the service is billed. This means you’ll need to explain the service to patients, obtain their consent (Note: Verbal consent is permitted per the CY 2025 Medicare physician fee schedule final rule), and either collect payment at the time of service (if that is your medical practice policy) or let patients know they will receive a bill.

4. Decide who will provide caregiver training services. Doctors, nurse practitioners, clinical nurse specialists, certified nurse midwives, physician assistants, clinical psychologists, and therapists may all render these services. 

5. Decide how to provide caregiver training services. As the codes new codes for caregiver training in direct care strategies and techniques indicate, you’ll need to decide whether to provide the service individually or in a group setting. When providing caregiver training in direct care services and techniques—and caregiver training in behavior management and modification—to individual caregivers, there is a 30-minute minimum time requirement for billing, so this is something to keep in mind for purposes of scheduling. 

For both caregiver training in direct care strategies and techniques as well as caregiver training in behavior management and modification, you’ll also need to decide whether you want to do it in person or via telehealth. Medicare has added all five new caregiver training codes to the Medicare Telehealth Services List on a provisional basis.

6. Understand when caregiver training services are a ‘sometimes therapy’ service. Physicians and certain nonphysician practitioners (i.e., nurse practitioners, physician assistants, or clinical nurse specialists) may bill caregiver training services in direct care strategies and techniques for patients under a home health plan of care, those who receive at-home therapy, or those who receive durable medical equipment services—but only when the services are outside a therapy plan of care and not integral to a therapy plan of care. 

Keep in mind that when physical therapists, occupational therapists, or speech-language pathologists provide caregiver training in direct care strategies and techniques, the service is always furnished under a therapy plan of care, and these providers must use the correct therapy modifier (i.e., -GP, -GO, or -GN) when billing.

Looking ahead
Caregiver training services can help you reduce previously uncompensated time while providing caregivers with critical information necessary to improve outcomes. Offering and billing for these services should be part of your plan for long-term financial sustainability. Learn how edgeMED can augment this plan.