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    v1.0.28
    OpenPayerBilling CodesPatient HistoryCPT cpt-1121f-subsequent-evaluation-program-measure-tracking
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    CPT 1121F: Subsequent Evaluation Documentation

    CPT code 1121F documents that a subsequent evaluation was performed for a condition relevant to the program measure being reported; it is a supplemental tracking code typically used to indicate follow-up evaluation services and is most often recorded in outpatient or ambulatory care settings where quality or program measures are tracked.

    For related coverage guidance, see recent payer policy updates: Prolonged Services for Labor Management, Prolonged Services for Labor Management, Cervical Cancer Screening.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A primary care clinician documents a follow-up visit focused on management of a chronic condition that is part of a program measure (for example, diabetes, hypertension, or smoking cessation). The visit is not a procedural service but a performance-tracking encounter where the clinician confirms continued evaluation and management of the condition; documentation specifically notes the subsequent evaluation relevant to the program measure being reported. The workflow: patient arrives for an outpatient visit at a primary care or chronic disease management clinic, vital signs and relevant labs or patient-reported outcomes are reviewed, medication adherence and treatment goals are assessed, a focused examination or counseling is performed as needed, and the clinician records the subsequent evaluation that satisfies the program-specific measure. The clinician or billing staff appends the supplemental tracking code 1121F on the claim or in quality reporting files to indicate the subsequent evaluation was documented for the measure.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommon E/M code used for the visit during which the subsequent evaluation is documented and 1121F is reported as supplemental tracking.
    99214Office or other outpatient visit for the evaluation and management of an established patient, typically 25 minutesUsed when a more complex follow-up visit documents the subsequent evaluation for the program measure.
    83036Hemoglobin; glycosylated (A1c)Laboratory test commonly performed or reviewed at a follow-up visit for diabetes measures; supports documentation for 1121F.
    81003Urinalysis, non-automated, without microscopyPoint-of-care test that may be performed or reviewed during the follow-up evaluation for relevant measures (e.g., renal monitoring).
    99406Smoking and tobacco use cessation counseling, intermediate, greater than 3 minutes up to 10 minutesCounseling codes that may accompany the documented subsequent evaluation for measures related to tobacco cessation.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    57CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    261QP2000XPhysical Therapy Clinic/CenterAn entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy i…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    225CX0006XOrientation and Mobility Training Rehabilitation CounselorOrientation and Mobility (O&M) specialists teach children and adults who have visual impairments the specific orientation skills used to find one's wa…
    225XG0600XGerontology Occupational TherapistOccupational therapists work with older adults in virtually every setting: assisted living, wellness programs, hospitals, nursing homes, senior center…
    2088P0231XPediatric Urology PhysicianSurgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her pra…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    B34.9Viral infection, unspecified
    E03.9Hypothyroidism, unspecified
    E11.9Type 2 diabetes mellitus without complications
    E78.5Hyperlipidemia, unspecified
    F17.210Nicotine dependence, cigarettes, uncomplicated
    F32.9Major depressive disorder, single episode, unspecified
    F41.9Anxiety disorder, unspecified
    G43.909Migraine, unspecified, not intractable, without status migrainosus
    H52.4Presbyopia
    I10Essential (primary) hypertension

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Obstetrics/Gynecology1 / 3

    8 rows

    PolicyPayerEffective Date
    Prolonged Services for Labor ManagementPremera Bluecross2027-01-01
    Prolonged Services for Labor ManagementPremera Bluecross2027-01-01
    Cervical Cancer ScreeningOscar Health2026-10-01
    Prenatal Testing for Fetal AneuploidyOscar Health2026-10-01
    Diagnosis of VaginitisOscar Health2026-10-01
    Prenatal Screening (Nongenetic)Oscar Health2026-10-01
    View PDF of Maternal Serum Biomarkers for Prediction of Adverse Obstetric Outcomes, Effective 10/1/2026 in MedicalBlue Cross Blue Shield - Rhode Island2026-10-01
    Maternal Serum Testing for Prediction of Adverse Obstetric OutcomesBluecross Idaho2026-09-01

    Related Codes

    CPT-1000F-CATEGORY-II-PERFORMANCE-MEASURE

    CPT 1000F: Tobacco Use Status Assessment

    CPT-1002F-NO-SUMMARY-AVAILABLE

    CPT 1002F: No Summary available

    CPT-1003F-PERFORMANCE-MEASURE

    CPT 1003F: Preventive Care Tobacco Use Counseling

    CPT-1004F-NO-SUMMARY-AVAILABLE

    CPT 1004F: Health Status Assessment

    CPT-1005F-NO-SUMMARY-AVAILABLE

    CPT 1005F: Peripheral Oxygen Saturation Assessment

    CPT-1006F-BRIEF-SUMMARY-NOT-AVAILABLE

    CPT 1006F: No Summary Available

    CPT-1007F-NO-SUMMARY-AVAILABLE

    CPT 1007F: Influenza Vaccination Administered

    CPT-1008F-UNSPECIFIED-SERVICE

    CPT 1008F: Depression Screening, Brief Standardized Assessment

    CPT-1010F-ANGINA-SEVERITY-ASSESSMENT-CAD-ACTIVITY-RESPONSE

    CPT 1010F: Angina Activity Assessment in Coronary Artery Disease

    CPT-1011F-THERAPEUTIC-MANAGEMENT-CORONARY-ARTERY-DISEASE-ANGINA

    CPT 1011F: Therapeutic Management for CAD with Angina

    Showing 1–10 of 81

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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