Evaluation and Management codes

All 159 billing codes in Evaluation and Management, each linking to its 2026 Medicare reimbursement rates by state.

159 CPT

99201New Patient Office Visit: Coverage and Documentation Requirements99202OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES99203OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES99204OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES99205OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES99211OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP99212OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN99213OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN99214OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN99215OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN992211ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES992221ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES992231ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES99231SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES99232SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES99233SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES99234HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN99235HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN99236HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN99238HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<99239HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN99241Office consultation for a new or established patient that requires these three key components: a problem-focused history; a problem-focused examination; and straightforward medical decision-making99242OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES99243OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES99244OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES99245OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES99251Inpatient consultation for a new or established patient which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making.99252IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES99253IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES99254IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES99255IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES99281EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP99282EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM99283EMERGENCY DEPARTMENT VISIT LOW MDM99284EMERGENCY DEPARTMENT VISIT MODERATE MDM99285EMERGENCY DEPARTMENT VISIT HIGH MDM99288PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS99291CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN99292CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN99304INITIAL NURSING FACILITY CARE SF/LOW MDM 25 MIN99305INITIAL NURSING FACILITY CARE MOD MDM 35 MINUTES99306INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES99307SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES99308SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES99309SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES99310SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES99315NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME99316NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME99341HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES99342HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES99344HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES99345HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES99347HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES99348HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES99349HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES99350HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES99354Prolonged Service With Direct Patient Contact99355Prolonged Service With Direct Patient Contact99358PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR99359PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES99360PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES99366TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN99367TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN99368TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN99374SUPVJ PT HOME HEALTH AGENCY MO 15-29 MINUTES99375SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>99377SUPERVISION HOSPICE PATIENT/MONTH 15-29 MIN99378SUPERVISION HOSPICE PATIENT/MONTH 30 MINUTES/>99379SUPERVISION NURS FACILITY PATIENT MO 15-29 MIN99380SUPERVISION NURS FACILITY PATIENT MONTH 30 MIN/>99381INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR99382INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS99383INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS99384INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR99385INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS99386INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS99387INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>99391PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y99392PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS99393PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS99394PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS99395PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS99396PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS99397PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER99401PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 15 MIN99402PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 30 MIN99403PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN99404PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN99406TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES99407TOBACCO USE CESSATION INTENSIVE >10 MINUTES99408ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN99409ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN99411PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M99412PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M99415PROLONGED CLINICAL STAFF SVC OFFICE/O/P 1ST HR99416PROLONGED CLINICAL STAFF SVC OFFICE/O/P EA ADDL99417PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES99418PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN99421ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES99422ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES99423ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES99424PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO99425PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO99426PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO99427PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO99429UNLISTED PREVENTIVE MEDICINE SERVICE99437CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO99439CHRONIC CARE MGMT SVC STAF EA ADDL 20 MIN CAL MO99441PHYS/QHP TELEPHONE EVALUATION 5-10 MIN99442PHYS/QHP TELEPHONE EVALUATION 11-20 MIN99443PHYS/QHP TELEPHONE EVALUATION 21-30 MIN99446NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN99447NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN99448NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN99449NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN99450BASIC LIFE AND/OR DISABILITY EXAMINATION99451NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN99452NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN99453REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP99454REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D99455WORK RELATED/MED DBLT XM TREATING PHYS99456WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS99459PELVIC EXAMINATION994601ST HOSP/BIRTHING CENTER CARE PER DAY NML NB994611ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER99462SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN994631ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT99464ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN99465DELIVERY/BIRTHING ROOM RESUSCITATION99466CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN99467CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN994681ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<99469SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<99471INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS99472SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO99473SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION99474SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD99475INITIAL PED CRITICAL CARE 2 THRU 5 YEARS99476SUBSEQUENT PED CRITICAL CARE 2 THRU 5 YEARS99477INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL99478SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS99479SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS99480SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS99483ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT99484CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS99485SUPERVISION INTERFACILITY TRANSPORT INIT 30 MIN99486SUPERVISION INTERFACILITY TRANSPORT ADDL 30 MIN99487COMPLEX CHRONIC CARE MGMT SVC 1ST 60 MIN CAL MO99489CPLX CHRONIC CARE MGMT SVC EA ADDL 30 MIN CAL MO99490CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO99491CHRONIC CARE MGMT SVC PHYS 1ST 30 MIN CAL MONTH994921ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS99493SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS994941ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS99495TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE99496TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE99497ADVANCE CARE PLANNING FIRST 30 MINS99498ADVANCE CARE PLANNING EA ADDL 30 MINS99499UNLISTED EVALUATION AND MANAGEMENT SERVICE
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