Q: Which provider specialties can order and bill for BoCA™?

BoCA™ can be ordered by licensed healthcare professionals including Medical Doctors (MDs), Doctors of Osteopathic Medicine (DOs), Nurse Practitioners (NPs), Physician Assistants (PAs), and psychology professionals such as PhDs and PsyDs. Eligibility depends on holding the required licensure and training per state regulations and insurer policies.

Q: Should BoCA™ be used for a one-time assessment or longitudinal monitoring?

BoCA™ is suitable for both one-time assessments and repeated use for longitudinal monitoring. A study demonstrated a strong correlation between BoCA™ and MoCA (R = 0.90, p < 0.001) when administered once, and repeated administrations showed no significant practice effect (β=0.03, SE=0.07, p = 0.68).

Q: What data is included in a BoCA™ report?

BoCA™ results are presented in a PDF report that includes the patient’s raw score, standard score, percentile, a visual bell-curve display of each domain, and longitudinal changes over time. The clinical trial cut point for normal cognition was a raw score of 26 and above.

Q: Does BoCA™ provide a diagnosis or medical opinion?

No, BoCA™ is not designed to diagnose cognitive conditions or replace professional medical advice. Although it is an FDA Class II Exempt medical device, results must be interpreted by a qualified healthcare professional as part of a comprehensive evaluation.

Q: What does the standard score mean?

A standard score shows how your performance compares to others of the same age and gender. A score of 100 indicates average performance, with most scores ranging between 85 and 115.

Q: What does it mean to be in a certain percentile?

Percentile ranking indicates how a test-taker’s performance compares to peers. For example, the 99th percentile means you outperformed 99% of test-takers, while the 50th percentile represents median performance.

Q: Can I use BoCA™ with children?

BoCA™ has been validated for individuals 21 years of age and older.

Q: What is a Cognitive Care Plan?

A Cognitive Care Plan involves an independent historian, multidimensional assessments of cognition, function, and safety, neuropsychiatric and behavioral evaluations, medication review, and caregiver needs assessment, culminating in a written care plan. Eligible providers include physicians, physician assistants, nurse practitioners, and clinical nurse specialists.

Question 1

What is BoCA™?

Accepted Answer

The Boston Cognitive Assessment (BoCA™) is an online tool that evaluates global cognition through tasks spanning eight cognitive domains, such as word list learning, delayed recall, numerical sequences, executive functioning, mental arithmetic, visuospatial reasoning, language, and orientation.

Question 2

Is BoCA™ a validated cognitive assessment?

Accepted Answer

Yes, BoCA™ has been validated in multiple studies. Participants with cognitive disorders scored significantly lower on both BoCA™ and the Montreal Cognitive Assessment (MoCA) compared to controls, and similar results were seen with the Telephone Interview for Cognitive Status (TICS). BoCA™ results align closely with MoCA (r = 0.85, p < 0.01) and TICS (r = 0.80, p < 0.01), and it showed strong test–retest reliability (r = 0.89, p < 0.001) one week after administration.

Question 3

Which provider specialties can order and bill for BoCA™?

Accepted Answer

BoCA™ can be ordered by licensed healthcare professionals including Medical Doctors (MDs), Doctors of Osteopathic Medicine (DOs), Nurse Practitioners (NPs), Physician Assistants (PAs), and psychology professionals such as PhDs and PsyDs. Eligibility depends on holding the required licensure and training per state regulations and insurer policies.

Question 4

Should BoCA™ be used for a one-time assessment or longitudinal monitoring?

Accepted Answer

BoCA™ is suitable for both one-time assessments and repeated use for longitudinal monitoring. A study demonstrated a strong correlation between BoCA™ and MoCA (R = 0.90, p < 0.001) when administered once, and repeated administrations showed no significant practice effect (β=0.03, SE=0.07, p = 0.68).

Question 5

What data is included in a BoCA™ report?

Accepted Answer

BoCA™ results are presented in a PDF report that includes the patient’s raw score, standard score, percentile, a visual bell-curve display of each domain, and longitudinal changes over time. The clinical trial cut point for normal cognition was a raw score of 26 and above.

Question 6

Does BoCA™ provide a diagnosis or medical opinion?

Accepted Answer

No, BoCA™ is not designed to diagnose cognitive conditions or replace professional medical advice. Although it is an FDA Class II Exempt medical device, results must be interpreted by a qualified healthcare professional as part of a comprehensive evaluation.

Question 7

What does the standard score mean?

Accepted Answer

A standard score shows how your performance compares to others of the same age and gender. A score of 100 indicates average performance, with most scores ranging between 85 and 115.

Question 8

What does it mean to be in a certain percentile?

Accepted Answer

Percentile ranking indicates how a test-taker’s performance compares to peers. For example, the 99th percentile means you outperformed 99% of test-takers, while the 50th percentile represents median performance.

Question 9

Can I use BoCA™ with children?

Accepted Answer

BoCA™ has been validated for individuals 21 years of age and older.

Question 10

What is a Cognitive Care Plan?

Accepted Answer

A Cognitive Care Plan involves an independent historian, multidimensional assessments of cognition, function, and safety, neuropsychiatric and behavioral evaluations, medication review, and caregiver needs assessment, culminating in a written care plan. Eligible providers include physicians, physician assistants, nurse practitioners, and clinical nurse specialists.

Question 11

Is the Boston Cognitive Care Plan™ a validated assessment tool?

Accepted Answer

While Medicare prefers standardized, validated tools, not all domains of cognitive care planning have such instruments. Boston Cognitive incorporates validated assessments where available and secures permissions to use them.

Question 12

Can you bill for Boston Cognitive Care Plan™ assessments under CPT 99483?

Accepted Answer

Boston Cognitive Care Plan™ assessments compile the data required to bill CPT 99483. Providers must complete a portion of the work and apply high-complexity medical decision-making to finalize and share the care plan with patients and caregivers.

Question 13

How can I access information about reimbursement for Boston Cognitive services?

Accepted Answer

You can download detailed reimbursement guides (PDFs) for BoCA™ (CPT 96132/96138) and Boston Cognitive Care Plan™ (CPT 99483), which include billing codes, documentation requirements, and best practices.

Question 14

How does the Boston Cognitive platform ensure HIPAA compliance for Covered Entities?

Accepted Answer

The platform uses encryption, secure access controls, regular audits, and a Business Associate Agreement (BAA) to protect PHI and support HIPAA compliance for Covered Entities.

Question 15

What are the system requirements to run assessments on the platform?

Accepted Answer

The platform is device-agnostic and runs on any internet-connected device across major browsers; the latest browser version is recommended for optimal performance.

Question 16

Can assessments be run on mobile devices, and are there specific device requirements?

Accepted Answer

Yes, assessments are compatible with smartphones and tablets and have been validated on devices with screens of 4 inches or larger.

Question 17

Are there specific internet speed requirements to run assessments smoothly?

Accepted Answer

A minimum internet speed of 5 Mbps is recommended to ensure smooth operation and fast result access.

Cognitive Assessment Solutions: Value Generation for Healthcare Payors

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