With the aging U.S. population, dementia care is becoming a national priority. In response, CMS has introduced new quality standards and care models aimed at improving outcomes for patients living with dementia.
This shift presents both an opportunity and a challenge for healthcare providers: How can they meet new CMS requirements while ensuring sustainable reimbursements?
Understanding the CMS Dementia Care Model
CMS is creating a path to deliver comprehensive, person-centered, high-quality dementia care across settings. Their new initiative emphasizes:
- Early detection and diagnosis
- Advanced care planning
- Coordinated care across multiple specialties
- Culturally sensitive and equitable services
These expectations require providers to rethink how they document care, code diagnoses, and report outcomes.
Documentation Challenges in Dementia Care
Dementia care requires detailed, longitudinal documentation:
- Cognitive assessments
- Functional status
- Caregiver involvement
- Behavioral health screenings
Failing to capture these elements can result in claim denials or substandard CMS ratings.
How Revenue Cycle Management Can Help
This is where specialized RCM services can make a difference. At Bannu Spy Health, we help dementia-focused providers:
- Use correct ICD-10 codes for neurocognitive disorders
- Identify and reduce coding gaps
- Audit charts for comprehensive care documentation
- Submit clean, CMS-compliant claims
A New Standard Requires a New Strategy
CMS is setting a high bar for dementia care—but with the right RCM partner, your practice can rise to meet it. Let Bannu Spy Health help you stay compliant, get paid accurately, and improve care delivery for one of our most vulnerable populations.