Summary & Overview

CPT 99368: Nonphysician Team Conference for Multispecialty Treatment Plan

CPT code 99368 captures a nonphysician qualified health care professional participating in a multidisciplinary team meeting to develop or review a treatment plan for a patient requiring care from multiple specialties. Nationally, this code reflects growing emphasis on team-based care for complex patients and is relevant to hospitals, specialty clinics, long-term care settings, and accountable care organizations focused on coordinated care.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose, typical settings of service, and common modifiers used with this code. The publication summarizes how 99368 fits into broader efforts to document interdisciplinary care, highlights billing considerations for nonphysician participation in team conferences, and points to where readers can find benchmarking and policy guidance.

This summary is intended for clinicians, coding professionals, and policy analysts seeking a national perspective on documentation and billing for interdisciplinary treatment planning involving nonphysician team members. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare99368CPTinterdisciplinary-careteam-conferencenonphysician-providertreatment-planningcare-coordinationhospital-serviceslong-term-care

Billing Code Overview

CPT code 99368 describes a nonphysician qualified health care professional joining a medical team meeting to discuss a treatment plan for a patient who requires attention from more than one medical specialty. This service is a form of interdisciplinary team conference involving a qualified nonphysician provider contributing clinical expertise to collaborative care planning.

Service type: Interdisciplinary team conference with nonphysician professional
Typical site of service: Hospital, outpatient specialty clinic, long-term care facility, or other settings where multidisciplinary teams convene for complex patient care planning

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with advanced congestive heart failure, chronic kidney disease, and poorly controlled diabetes is hospitalized for worsening dyspnea and volume overload. Multiple specialties (cardiology, nephrology, endocrinology, and case management) convene a multidisciplinary care conference to establish a coordinated treatment plan addressing diuresis strategy, medication adjustments, renal dosing, and goals-of-care. A nurse practitioner from hospital medicine joins the meeting as a nonphysician qualified health care professional to contribute clinical assessment data and care coordination input. The meeting includes review of diagnostics, medication reconciliation, assessment of procedural needs, and assignment of follow-up responsibilities. Documentation includes attendance, topics discussed, proposed treatment plan, time spent, and the nonphysician provider’s specific contributions to the multidisciplinary treatment plan.

Coding Specifications

Modifier	Description	When to Use
`11`	Increased procedural service	When the nonphysician’s participation required substantially more work than typical for the meeting
`22`	Increased procedural services (unusual procedural services)

Taxonomy Code	Specialty	Notes
371400000X	Hospitalist	Frequently participates in inpatient multidisciplinary meetings as nonphysician or physician extender
363L00000X	Nurse Practitioner	Common nonphysician qualified health care professional joining specialty teams for care planning
207RH0000X	Cardiovascular Disease (Cardiologist)	Core specialty for complex cardiac patients in team-based treatment planning
163W00000X	Nephrology	Involved when renal dosing and dialysis decisions are part of the treatment plan
208000000X	Internal Medicine	Primary team or consultative specialty coordinating multi-specialty care

ICD-10 Code	Description	Clinical Relevance
`I50.32`	Chronic diastolic (congestive) heart failure	Common indication for multidisciplinary planning involving cardiology and nephrology
`I50.33`	Acute on chronic diastolic heart failure	Represents acute exacerbation prompting team-based treatment decisions
`N18.6`	End stage renal disease	Frequently requires nephrology input for medication dosing and dialysis planning
`E11.9`	Type 2 diabetes mellitus without complications	Common comorbidity affecting medication choices and peri-procedural management
`J96.00`	Acute respiratory failure, unspecified whether with hypoxia or hypercapnia	Severe presentations that may trigger urgent multidisciplinary coordination

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99366`	Medical team conference by a physician with interdisciplinary team, face-to-face with patient/family; first hour	Often billed by a physician for the initial interdisciplinary team meeting when physician-led discussion is required
`99367`	Medical team conference by a physician with interdisciplinary team, each additional 30 minutes	Used to report extended physician-led team conferences beyond the first hour
`99368`	Nonphysician qualified health care professional joining a medical team in a meeting to discuss a treatment plan for a patient who requires attention from more than one medical specialty	Primary code describing nonphysician participation in a multidisciplinary treatment planning meeting
`99499`	Unlisted evaluation and management service	Used when an atypical team-based service does not fit standard codes and detailed documentation supports an unlisted service
`99490`	Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month	May be performed as follow-up care coordination after multidisciplinary meeting to manage chronic conditions

OpenPayer