Summary & Overview
CPT 99384: Initial Preventive Visit for Adolescents
Headline: CPT 99384: Initial Preventive Visit for Adolescents
Lead: CPT 99384 denotes the initial comprehensive preventive medicine evaluation and management visit for a new adolescent patient (ages 12–17). This code captures a multi-component preventive encounter that combines history, examination, counseling/anticipatory guidance, risk-reduction interventions, and any ordering of appropriate laboratory or diagnostic tests in an outpatient office setting.
What this code represents and why it matters: As preventive services for adolescents gain emphasis, CPT 99384 is a central code for documenting and billing the first comprehensive preventive visit for new adolescent patients. Proper use supports clinical continuity, preventive screening, and population health initiatives aimed at immunization, mental health screening, and risk counseling during a key developmental window.
Key payers covered: The analysis covers national commercial payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Overview of reader takeaways: Readers will find a concise description of the services represented by CPT 99384, payer coverage context, common billing considerations, and how this code fits among age-based initial preventive visit codes. The publication highlights clinical context for the adolescent preventive visit and operational notes relevant to outpatient practice workflows. Data not available in the input for service-line specifics and payer policy nuances is noted where applicable.
CPT Code Overview
CPT 99384 is an initial comprehensive preventive medicine evaluation and management service for a new patient who is an adolescent, age 12 through 17 years. The service includes an age- and gender-appropriate history, physical examination, counseling and anticipatory guidance, risk factor reduction interventions, and the ordering of laboratory or diagnostic procedures as appropriate.
Service Type: Preventive Medicine / Evaluation and Management
Typical Site of Service: Office (Outpatient) (POS 11)
Clinical & Coding Specifications
Clinical Context
A 14-year-old adolescent presents to an outpatient office visit with a new primary care provider for a comprehensive preventive health evaluation. The visit includes an age- and gender-appropriate medical, social, and developmental history; a focused physical examination; counseling and anticipatory guidance (nutrition, immunizations, mental health screening, risk-reduction counseling); and ordering of age-appropriate laboratory or diagnostic tests. Nursing staff may obtain vital signs and growth measurements before the clinician encounter. The clinician documents review of past medical records, immunization status, risk assessment, and formulates a preventive care plan. The encounter is coded as 99384 when the patient is a new patient aged 12 through 17 years undergoing an initial comprehensive preventive medicine evaluation.
Coding Specifications
Modifier 25
- Use when a significant, separately identifiable Evaluation and Management service is provided by the same physician on the same day as another procedure or service.
Modifier 33
- Use to indicate that the service is a preventive service.
Associated provider taxonomies
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208000000X: Pediatrics Physician -
207Q00000X: