National standards for asthma self-management education

Area of Science:

• Pulmonology and Respiratory Medicine
• Health Services Research
• Medical Education

Background:

• Reimbursement for asthma education in the US is hindered by the absence of a recognized, standardized curriculum.
• Current Procedural Terminology (CPT) codes 98960-98962 allow for reimbursement of self-management education when a standardized curriculum is used.
• Lack of a standardized curriculum prevents healthcare providers from obtaining payer reimbursement for crucial asthma self-management education services.

Framework:

• A standardized asthma self-management education curriculum was developed through collaboration among leading allergy, asthma, and immunology professional organizations.
• The curriculum development involved representatives from multiple key organizations, including the Joint Council of Allergy, Asthma, and Immunology and the American Lung Association.
• The initiative aimed to create a guideline that would facilitate payer reimbursement for asthma self-management education programs.

Implementation:

• The Task Force initiated the process by reviewing existing standards, specifically the American Lung Association and American Thoracic Society's Operational Standards for Asthma Education.
• The National Asthma Educator Certification Board's members contributed by incorporating comments, rationale, and references into the draft curriculum.
• Final reviews of the proposed standards were completed by the Task Force and national healthcare professional organizations in September 2014.

Implications:

• The developed curriculum meets the criteria outlined in CPT codes 98960-98962, thereby addressing a significant barrier to reimbursement.
• This standardized curriculum establishes the minimum requirements for effective asthma self-management education for both patients and caregivers.
• Implementation of this guideline is expected to improve the consistency and quality of asthma self-management education, ultimately enhancing patient care and facilitating provider reimbursement.