CPT code 99342 identifies a new-patient evaluation and management (E/M) visit performed in the patient’s home or residence involving a low level of medical decision making or at least 30 minutes of total time on a single date. This code captures clinician encounters outside traditional office settings and supports continuity of care for patients who are homebound, have mobility challenges, or require in-home assessment. Nationally, accurate use of this code affects access to home-based primary and specialty care and informs payment for community-based services.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical and billing context for use of 99342, typical settings where it applies, common modifiers associated with home visits, and the items to consider when documenting time and decision making for a new-patient home E/M. The publication summarizes benchmarks and coding relationships where available, highlights policy updates that affect home/residence E/M coding and reimbursement, and provides practical clarity on when 99342 is the appropriate code choice. Data not available in the input is noted where applicable.