Summary & Overview
CPT 99390: Periodic Preventive Medicine Visit for Patients 65+
Headline: Preventive Medicine Visit for Older Established Patients — CPT 99390
Lead: CPT 99390 denotes a comprehensive periodic preventive medicine reevaluation and management visit for established patients aged 65 and older. This preventive medicine code captures annual or periodic wellness-focused encounters that prioritize screening, counseling, and health maintenance for older adults.
Why it matters nationally: Preventive visits for the 65+ population are central to early detection and chronic disease prevention, with implications for care coordination and downstream utilization. Standardized coding for these visits enables consistent capture of preventive services in ambulatory settings and supports population health initiatives targeting older adults.
Payers covered: The analysis references Blue Cross Blue Shield as the payer discussed.
What readers will learn: The publication provides benchmarks and clinical context for CPT 99390, explains common billing relationships to related evaluation and management codes, and outlines typical sites of service and clinical intent for preventive medicine visits in older adults. It highlights where CPT 99390 fits within preventive care coding for established patients and situates the code relative to related services such as periodic comprehensive preventive medicine visits and common outpatient E/M encounters.
Scope note: Service line metadata is not available in the input. The content focuses on coding description, clinical context, payer coverage, and related procedural context for national audiences.
CPT Code Overview
CPT 99390 is a periodic comprehensive preventive medicine reevaluation and management service for an established patient aged 65 years and older. This code describes a preventive medicine visit focused on age-appropriate screening, counseling, and health maintenance for older adults. The service type is Preventive Medicine and the typical site of service is Office (POS 11).
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
An established patient aged 65 years or older presents to a primary care office (POS 11) for a periodic comprehensive preventive medicine reevaluation and management visit. The visit is scheduled as a preventive medicine encounter focused on health maintenance, age-appropriate screenings, medication review, vaccination status, cognitive and functional assessment, and counseling on lifestyle modifications. The clinical workflow typically includes pre-visit medication reconciliation and vitals, review of prior preventive screening results (e.g., colorectal cancer screening, diabetes risk), point-of-care testing as indicated, comprehensive history and systems review, preventive counseling, and documentation of findings and screening orders. If abnormal findings are identified during the visit, problem-focused work-up or scheduling of follow-up diagnostic testing may be initiated.
Coding Specifications
Modifier 25
- Description: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service.
- When to use: Use when a significant, separately identifiable E/M service is performed on the same day as another procedure or service and must be documented as distinct from the preventive medicine service.
Modifier 33
- Description: Preventive Services.
- When to use: Use to indicate services that are preventive in nature and may be covered without patient cost-sharing under specific payor policies.
Associated provider taxonomies