CPT 99075: Medical Record Review and Sworn Medical Opinion
CPT code 99075 documents a provider’s review of medical records and the rendering of a sworn medical opinion based on the facts made available. This code captures medico-legal or administrative activities rather than direct patient care and is relevant nationally where clinicians participate in legal proceedings, disability determinations, or independent medical evaluations. Coverage and payment for this type of service vary across major payers and carry implications for provider administrative workload and documentation standards.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national-level overview of what CPT code 99075 represents, typical service context, and the practical implications for billing and record-keeping. The publication outlines common payment considerations, typical sites of service, and operational points that facilities and clinicians should track when providing sworn medical opinions. Benchmarks, policy updates, and clinical context related to administrative medico-legal services are summarized to help billing leaders and compliance staff align coding practices with payer expectations.
Data not available in the input where payer-specific rates, associated taxonomies, ICD-10 pairings, or related codes would normally appear.
Customize your policy alerts
Sign up for cpt 99075 policy alerts
Get alerted when payer policies referencing 99075 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 99075 describes a provider review of medical records followed by rendering a sworn medical opinion based on the facts made available. The service type is legal or administrative medico-legal testimony/opinion derived from review of clinical documents. The typical site of service is non-clinical or administrative settings, such as a provider office or a legal proceeding location where the sworn opinion is delivered.
Data not available in the input.