CPT 99318: Subsequent Nursing Facility Care (Deleted)

CPT code 99318 was a subsequent nursing facility care code that was deleted effective Jan. 1, 2023. Its deletion affects clinical documentation and billing for follow-up care provided in skilled nursing and long-term care facilities. Nationally, the removal of this code requires clinicians and billing teams to reference current applicable CPT guidance and remaining subsequent nursing facility codes when documenting and submitting claims for post-acute and long-term facility follow-up services.

This analysis covers payer treatment relevant to the code, with payers in scope including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's status, its historical clinical context for nursing facility follow-up care, how common related codes were used prior to deletion, and references to the set of subsequent nursing facility care codes 99307–99310 that were associated with 99318 in practice. The publication highlights policy updates tied to code deletion, implications for billing workflows, and considerations for medical record documentation when 99318 is encountered in historical records.

Data not available in the input for payer-specific payment benchmarks is noted where applicable. The content is intended for a national audience of clinicians, coding specialists, and revenue cycle professionals seeking clarity on the status and context of CPT code 99318.

Billing Code Overview

CPT code 99318 is a deleted code, effective Jan. 1, 2023. The code previously described a service related to subsequent nursing facility care and is no longer valid for reporting after the deletion date.

Service type: Subsequent nursing facility care (historical)

Typical site of service: Skilled nursing facility or nursing facility (historical)

Clinical Context

A typical patient is an older adult residing in a skilled nursing facility who requires subsequent nursing facility care follow-up by a geriatric clinician. The resident is seen for ongoing management of chronic conditions, assessment of functional status, medication reconciliation, and review of new complaints such as memory concerns or progressive debility. The clinician documents time-based face-to-face nursing facility visits addressing changes in cognition, activities of daily living, fall risk, and treatment response. Encounter diagnoses commonly include Z00.00, Z00.01, Z13.89, R41.3, and R54. The clinical workflow includes review of nursing and therapy notes, direct patient assessment at the bedside, focused exam, adjustment of medications or orders, communication with the facility team and family, and documentation of the visit in the resident’s medical record. This deleted code historically accompanied subsequent nursing facility care codes to report extended services or additional visit time and would be replaced now by current applicable subsequent care or prolonged service reporting according to payer guidance.

Coding Specifications

Modifier	Description	When to Use

Taxonomy Code	Specialty	Notes
`207QG0300X`	Geriatric Medicine Physician	Specialist in comprehensive care of older adults; commonly provides nursing facility follow-up.
`207RG0300X`	Geriatric Medicine (Internal Medicine) Physician	Internal medicine-trained geriatrician who manages complex medical issues in long-term care residents.
`163WG0000X`	Geriatric Nurse Practitioner	Advanced practice clinician providing primary and chronic care management in nursing facilities.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z00.00`	Encounter for general adult medical examination without abnormal findings	Used for routine periodic evaluation of an older adult resident when no abnormal findings are documented during the nursing facility follow-up visit.
`Z00.01`	Encounter for general adult medical examination with abnormal findings	Used when the exam during the nursing facility visit identifies abnormal findings requiring follow-up or management changes.
`Z13.89`	Encounter for screening for other disorder	Used when the visit includes screening activities (for example cognitive screening or fall risk assessment) during the nursing facility encounter.
`R41.3`	Other amnesia	Relevant when memory impairment or amnestic symptoms are addressed during the visit and influence management and monitoring.
`R54`	Age-related physical debility	Relevant when the visit focuses on functional decline, frailty, or progressive debility requiring care plan adjustments during the nursing facility follow-up.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99307‑99310`	Subsequent nursing facility care codes	These codes represent the standard subsequent nursing facility visit levels with which the deleted code `99318` was historically reported to indicate extended or additional nursing facility care services; they are the primary codes for serial nursing facility visits.

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Summary & Overview