Summary & Overview

CPT 99451: Interprofessional Remote Consultation with Written Report

CPT code 99451 denotes an interprofessional, non–face-to-face consultation in which a consulting physician or other qualified healthcare professional spends five minutes or more communicating via telephone, internet, or the electronic health record and delivers a written report to the requesting clinician. This code reflects the growing use of electronic and telephonic clinician-to-clinician consultations to support care coordination, reduce unnecessary patient visits, and document specialist input in longitudinal care.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical role, common use cases, and the service context for billing 99451, plus a summary of relevant payer coverage patterns and benchmarking considerations where available. The publication covers practical policy and billing updates that affect national adoption, typical sites of service, and how 99451 integrates with broader interprofessional consultation workflows. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare99451CPTinterprofessional consultationtelehealthelectronic consultationcare coordinationnon-face-to-face servicephysician-to-physician

Billing Code Overview

CPT code 99451 describes a consulting physician or other qualified healthcare professional providing a consultation via telephone, internet, or electronic health record (EHR) that lasts 5 minutes or more and culminates in a written report to the requesting physician or qualified healthcare professional.

Service type: Interprofessional electronic/telephone consultation with written report
Typical site of service: Non–face-to-face, remote consultation conducted via telephone, internet, or through an EHR; the service is delivered outside of a direct patient visit setting, supporting care coordination between clinicians.

Clinical & Coding Specifications

Clinical Context

A 72-year-old primary care physician requests a short specialist consultation about a recent change in a patient's anticoagulation regimen after a minor gastrointestinal bleed. The consulting cardiologist reviews the electronic health record, including recent labs, medication list, and endoscopy report, and communicates with the requesting physician via secure EHR messaging. The consultant documents a focused review, provides clinical recommendations about resumption and dosing of anticoagulation, and uploads a written report to the EHR for the requesting clinician. The encounter is non–face-to-face, initiated by the requesting clinician, and the consulting clinician spends at least five minutes providing clinical input and a written report back to the requester. Typical workflow includes an initial request from the treating clinician, chart review by the consultant, optional asynchronous electronic communication, and a finalized written consult note sent to the requesting clinician and filed in the patient's record.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional component of a service; rarely applied to this consult code but applicable if splitting global services.
`32`

Taxonomy Code	Specialty	Notes
208000000X	Cardiology	Common specialty providing remote consults about anticoagulation, arrhythmia, and cardiology medication management.
207R00000X	Internal Medicine	Frequently performs and requests consults for complex medical management and coordinates care with consultants.
207Q00000X	Family Medicine	Typical requesting provider and sometimes providing consultant for broader primary care–level consultative guidance.
208000000X-Subspecialty (e.g., Electrophysiology)	Cardiology Subspecialty	Used when subspecialty cardiologists provide focused electronic consults (electrophysiology input, device management).
208D00000X	Gastroenterology	Common consultant when GI bleeding or anticoagulation-related issues are the focus of the request.

ICD-10 Code	Description	Clinical Relevance
`I82.403`	Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral	Consults about anticoagulation management and dosing decisions are commonly requested for acute DVT.
`I48.91`	Unspecified atrial fibrillation	Cardiology consults for anticoagulation decision-making in atrial fibrillation are frequent reasons for interprofessional electronic consults.
`K92.2`	Gastrointestinal hemorrhage, unspecified	Relevant when anticoagulation must be balanced against recent GI bleeding; consultant advises on timing of resumption.
`D68.9`	Coagulation defect, unspecified	Hematology or specialty consults may be requested to interpret coagulation studies and guide anticoagulant therapy.
`I26.99`	Other pulmonary embolism without acute cor pulmonale	Consulting specialists provide recommendations on anticoagulation duration and follow-up.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99446`	Interprofessional telephone/Internet/electronic health record consultation, typically 5–10 minutes of medical consultative discussion and review by consultative physician or other qualified health care professional	Alternative interprofessional consult codes with time-based tiers that may be used when there is interactive discussion; relates as an alternative billing option depending on time and complexity.
`99447`	Interprofessional telephone/Internet/electronic health record consultation, typically 11–20 minutes of medical consultative discussion and review	Used when the consult requires more time than `99451`; selected based on time spent when interactive discussion occurs.
`99452`	Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes	Represents services by the requesting clinician coordinating the consultation; complements `99451` which is the consultant's report.
`99458`	Each additional 20 minutes added to `99457` for remote physiological monitoring treatment management	May be part of broader remote care workflows when ongoing remote management follows an interprofessional consult.
`99457`	Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional, first 20 minutes	Related when remote monitoring findings prompt an interprofessional consult documented with a written report.

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