Summary & Overview
CPT 99380: Nursing Facility Care Supervision and Plan of Care
CPT code 99380 designates a physician or qualified provider’s supervisory role in the care of a patient residing in a nursing facility, documenting time spent overseeing the patient’s plan of care as indirect care. This code is important nationally because it captures provider responsibility for care coordination and oversight in post-acute and long-term care settings, affecting clinical documentation, facility workflows, and payment reporting for supervisory services. Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise understanding of the clinical intent and typical setting for 99380, how the service differs from direct hands-on nursing or face-to-face evaluation, and what to expect in payer coverage considerations and coding practice. The publication provides benchmarks where available, highlights relevant policy and documentation requirements that influence billing for supervisory services in nursing facilities, and situates 99380 within the broader set of post-acute care billing practices. Data not provided in the input—such as specific associated taxonomies, ICD-10 mappings, and related codes—is noted as unavailable for this summary.
Billing Code Overview
CPT code 99380 reports a provider-supervised plan of care for a nursing facility resident, where the provider oversees and directs the care delivered to the patient. The service represents indirect care supervision rather than the hands-on provision of daily nursing tasks.
Service type: Supervisory care / Nursing facility care coordination
Typical site of service: Nursing facility (skilled nursing facility or long-term care facility)
Clinical & Coding Specifications
Clinical Context
A nursing facility medical director supervises and oversees the interdisciplinary plan of care for a long-term care resident. The resident is an 82-year-old man with advanced dementia, stage 3 pressure ulcer on the sacrum, chronic congestive heart failure, and recurrent urinary tract infections. The physician or qualified non-physician practitioner documents a review of the resident’s current status, medications, wound care plan, therapy recommendations, and coordination with nursing and ancillary staff. The supervisor spends more than 30 minutes in indirect care activities (record review, care team coordination, orders review, and documentation) and provides supervisory oversight of the nursing facility care plan. The typical site of service is a skilled nursing facility or nursing home; the clinical workflow includes chart review, interdisciplinary team meetings or communications, updating the care plan, and intermittent direct resident assessment as needed, followed by documentation of supervisory services in the medical record and billing using the appropriate CPT code.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service | Use when the supervising provider documents a distinct face-to-face E/M visit in addition to supervisory indirect care time |