Evaluation and Management

13 categories, 176 billing codes.

New patient office visits4 codes
99202New patient office/outpatient visit, straightforward medical decision making 99203New patient office/outpatient visit, low medical decision making 99204New patient office/outpatient visit, moderate medical decision making 99205New patient office/outpatient visit, high medical decision making
Established patient office visits5 codes
99211Established patient office/outpatient visit, may not require physician presence 99212Established patient office/outpatient visit, straightforward medical decision making 99213Established patient office/outpatient visit, low medical decision making 99214Established patient office/outpatient visit, moderate medical decision making 99215Established patient office/outpatient visit, high medical decision making
Hospital inpatient visits8 codes
99221Initial hospital inpatient or observation care, straightforward to low medical decision making 99222Initial hospital inpatient or observation care, moderate medical decision making 99223Initial hospital inpatient or observation care, high medical decision making 99231Subsequent hospital inpatient or observation care, straightforward to low medical decision making 99232Subsequent hospital inpatient or observation care, moderate medical decision making 99233Subsequent hospital inpatient or observation care, high medical decision making 99238Hospital inpatient or observation discharge day management, 30 minutes or less 99239Hospital inpatient or observation discharge day management, more than 30 minutes
Hospital outpatient visits4 codes
99234Hospital inpatient or observation care, same date admission and discharge, straightforward to low medical decision making 99235Hospital inpatient or observation care, same date admission and discharge, moderate medical decision making 99236Hospital inpatient or observation care, same date admission and discharge, high medical decision making G0463Hospital outpatient clinic visit for assessment and management of a patient
Emergency department visits5 codes
99281Emergency department visit, minimal problem, may not require physician presence 99282Emergency department visit, straightforward medical decision making 99283Emergency department visit, low medical decision making 99284Emergency department visit, moderate medical decision making 99285Emergency department visit, high medical decision making
Nursing facility visits9 codes
99304Initial nursing facility care, straightforward to low medical decision making 99305Initial nursing facility care, moderate medical decision making 99306Initial nursing facility care, high medical decision making 99307Subsequent nursing facility care, straightforward medical decision making 99308Subsequent nursing facility care, low medical decision making 99309Subsequent nursing facility care, moderate medical decision making 99310Subsequent nursing facility care, high medical decision making 99315Nursing facility discharge day management, 30 minutes or less 99316Nursing facility discharge day management, more than 30 minutes
Home and residence visits8 codes
99341Home or residence visit, new patient, straightforward medical decision making 99342Home or residence visit, new patient, low medical decision making 99344Home or residence visit, new patient, moderate medical decision making 99345Home or residence visit, new patient, high medical decision making 99347Home or residence visit, established patient, straightforward medical decision making 99348Home or residence visit, established patient, low medical decision making 99349Home or residence visit, established patient, moderate medical decision making 99350Home or residence visit, established patient, high medical decision making
Preventive and wellness visits17 codes
99381Initial preventive medicine visit, new patient, infant (under 1 year)99382Initial preventive medicine visit, new patient, early childhood (1-4 years)99383Initial preventive medicine visit, new patient, late childhood (5-11 years)99384Initial preventive medicine visit, new patient, adolescent (12-17 years)99385Initial preventive medicine visit, new patient, 18-39 years 99386Initial preventive medicine visit, new patient, 40-64 years 99387Initial preventive medicine visit, new patient, 65 years and older 99391Periodic preventive medicine visit, established patient, infant (under 1 year)99392Periodic preventive medicine visit, established patient, early childhood (1-4 years)99393Periodic preventive medicine visit, established patient, late childhood (5-11 years)99394Periodic preventive medicine visit, established patient, adolescent (12-17 years)99395Periodic preventive medicine visit, established patient, 18-39 years 99396Periodic preventive medicine visit, established patient, 40-64 years 99397Periodic preventive medicine visit, established patient, 65 years and older G0402Initial Preventive Physical Examination (Medicare Welcome to Medicare visit)G0438Annual wellness visit, initial visit (Medicare)G0439Annual wellness visit, subsequent visit (Medicare)
Consultations8 codes
99242Office or outpatient consultation, low medical decision making 99243Office or outpatient consultation, moderate medical decision making (lower)99244Office or outpatient consultation, moderate medical decision making 99245Office or outpatient consultation, high medical decision making 99252Inpatient or observation consultation, straightforward to low medical decision making 99253Inpatient or observation consultation, low medical decision making 99254Inpatient or observation consultation, moderate medical decision making 99255Inpatient or observation consultation, high medical decision making
Telehealth visits23 codes
98000Synchronous audio-video telemedicine E/M service, new patient, straightforward medical decision making 98001Synchronous audio-video telemedicine E/M service, new patient, low medical decision making 98002Synchronous audio-video telemedicine E/M service, new patient, moderate medical decision making 98003Synchronous audio-video telemedicine E/M service, new patient, high medical decision making 98004Synchronous audio-video telemedicine E/M service, established patient, straightforward medical decision making 98005Synchronous audio-video telemedicine E/M service, established patient, low medical decision making 98006Synchronous audio-video telemedicine E/M service, established patient, moderate medical decision making 98007Synchronous audio-video telemedicine E/M service, established patient, high medical decision making 98008Synchronous audio-only telemedicine E/M service, new patient, straightforward medical decision making 98009Synchronous audio-only telemedicine E/M service, new patient, low medical decision making 98010Synchronous audio-only telemedicine E/M service, new patient, moderate medical decision making 98011Synchronous audio-only telemedicine E/M service, new patient, high medical decision making 98012Synchronous audio-only telemedicine E/M service, established patient, straightforward medical decision making 98013Synchronous audio-only telemedicine E/M service, established patient, low medical decision making 98014Synchronous audio-only telemedicine E/M service, established patient, moderate medical decision making 98015Synchronous audio-only telemedicine E/M service, established patient, high medical decision making 98016Brief communication technology-based virtual check-in, established patient, 5-10 minutes 99421Online digital E/M service, established patient, 5-10 minutes cumulative over 7 days 99422Online digital E/M service, established patient, 11-20 minutes cumulative over 7 days 99423Online digital E/M service, established patient, 21 minutes or more cumulative over 7 days G0406Follow-up inpatient telehealth consultation, limited (Medicare)G0407Follow-up inpatient telehealth consultation, intermediate (Medicare)G0408Follow-up inpatient telehealth consultation, complex (Medicare)
Care management19 codes
99424Principal care management services, first 30 minutes per month, physician or QHP 99425Principal care management services, each additional 30 minutes per month, physician or QHP (add-on)99426Principal care management services, first 30 minutes per month, clinical staff 99427Principal care management services, each additional 30 minutes per month, clinical staff (add-on)99439Chronic care management services, non-complex, each additional 20 minutes per month (add-on)99484General behavioral health integration care management, first 20 minutes per month 99487Complex chronic care management services, first 60 minutes per month 99489Complex chronic care management services, each additional 30 minutes per month (add-on)99490Chronic care management services, non-complex, first 20 minutes per month 99491Chronic care management services personally performed by physician/QHP, first 30 minutes per month 99492Psychiatric collaborative care management, initial 70 minutes in first month 99493Psychiatric collaborative care management, subsequent 60 minutes per month 99494Psychiatric collaborative care management, each additional 30 minutes per month (add-on)99495Transitional care management services, moderate complexity medical decision making 99496Transitional care management services, high complexity medical decision making G0318Prolonged home or residence evaluation and management service (add-on)G0556Advanced primary care management, level 1 (0-1 chronic conditions)G0557Advanced primary care management, level 2 (2 or more chronic conditions)G0558Advanced primary care management, level 3 (2 or more chronic conditions, Qualified Medicare Beneficiary)
Critical care9 codes
99291Critical care, evaluation and management of the critically ill or injured patient, first 30-74 minutes 99292Critical care, each additional 30 minutes (add-on)99468Neonatal critical care, initial inpatient care, per day, for a critically ill neonate (28 days of age or younger)99469Neonatal critical care, subsequent inpatient care, per day, for a critically ill neonate 99471Pediatric critical care, initial inpatient care, per day, for a critically ill infant (29 days through 24 months)99472Pediatric critical care, subsequent inpatient care, per day, for a critically ill infant 99475Pediatric critical care, initial inpatient care, per day, for a critically ill patient (2 through 5 years)99476Pediatric critical care, subsequent inpatient care, per day, for a critically ill patient 99477Initial hospital care, per day, for a neonate requiring intensive observation, not critically ill
Additional evaluation and management services57 codes
99201New Patient Office Visit: Coverage and Documentation Requirements 99241Office 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-making 99251Inpatient 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.99288Phys/qhp Direction Emergency Medical Systems 99354Prolonged Service With Direct Patient Contact 99355Prolonged Service With Direct Patient Contact 99358Prolng E/m Svc Before&/after Dir Pt Care 1st Hr 99359Prolng E/m Before&/after Dir Care Ea 30 Minutes 99360Phys Standby Svc Prolng Phys Attn Ea 30 Minutes 99366Team Conference Face-to-face Nonphysician 99367Team Conference Non-face-to-face Physician 99368Team Conference Non-face-to-face Nonphysician 99374Supvj Pt Home Health Agency Mo 15-29 Minutes 99375Supervision Pt Home Health Agency Month 30 Min/>99377Supervision Hospice Patient/month 15-29 Min 99378Supervision Hospice Patient/month 30 Minutes/>99379Supervision Nurs Facility Patient Mo 15-29 Min 99380Supervision Nurs Facility Patient Month 30 Min/>99415Prolonged Clinical Staff Svc Office/o/p 1st Hr 99416Prolonged Clinical Staff Svc Office/o/p Ea Addl 99417Prolonged Outpatient E/m Service Each 15 Minutes 99418Prolonged Inpatient/observation Em Svc Ea 15 Min 99437Chronic Care Mgmt Svc Phys Ea Addl 30 Min Cal Mo 99441Phys/qhp Telephone Evaluation 5-10 Min 99442Phys/qhp Telephone Evaluation 11-20 Min 99443Phys/qhp Telephone Evaluation 21-30 Min 99446Ntrprof Phone/ntrnet/ehr Assmt&mgmt 5-10 Min 99447Ntrprof Phone/ntrnet/ehr Assmt&mgmt 11-20 Min 99448Ntrprof Phone/ntrnet/ehr Assmt&mgmt 21-30 Min 99449Ntrprof Phone/ntrnet/ehr Assmt&mgmt 31/> Min 99450Basic Life And/or Disability Examination 99451Ntrprof Phone/ntrnet/ehr Assmt&mgmt 5/> Min 99452Ntrprof Phone/ntrnet/ehr Referral Svc 30 Min 99453Rem Mntr Physiol Param 1st Set Up Pt Educaj Eqp 99454Rem Mntr Physiol Param 1st Dev Supply Ea 30 D 99455Work Related/med Dblt Xm Treating Phys 99456Work Related/med Dblt Xm Oth/thn Treating Phys 99459Pelvic Examination 994601st Hosp/birthing Center Care Per Day Nml Nb 994611st Care Pr Day Nml Nb Xcpt Hosp/birthing Center 99462Subq Hospital Care Per Day E/m Normal Newborn 994631st Hosp/birthing Center Nb Admit & Dschg Sm Dat 99464Attn At Delivery 1st Stabilization of Newborn 99465Delivery/birthing Room Resuscitation 99466Critical Care Interfacility Transport 30-74 Min 99467Critical Care Interfacility Transport Ea 30 Min 99473Self-meas Bp Pt Educaj/traing & Dev Calibration 99474Self-meas Bp 2 Readg 1 Min Apart Bid 30 Day Pd 99478Subsequent Intensive Care Infant < 1500 Grams 99479Subsequent Intensive Care Infant 1500-2500 Grams 99480Subsequent Intensive Care Infant 2501-5000 Grams 99483Assmt & Care Planning Pt W/cognitive Impairment 99485Supervision Interfacility Transport Init 30 Min 99486Supervision Interfacility Transport Addl 30 Min 99497Advance Care Planning First 30 Mins 99498Advance Care Planning Ea Addl 30 Mins 99499Unlisted Evaluation and Management Service