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    v1.0.30
    OpenPayerBilling CodesBasic Life and/or Disability Evaluation ServicesCPT cpt-99452-interprofessional-communication-30-minutes
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    CPT 99452: 30-Minute Interprofessional Telephone or Electronic Consultation

    Medicare pays $38 on average nationally for this procedure.

    CPT code 99452 describes 30 minutes of a treating or requesting physician’s or other qualified healthcare professional’s time spent furnishing healthcare information to a consultant via telephone, secure text, email, or other electronic media; this is an interprofessional consultative communication service typically provided as a non-face-to-face, office-based or telehealth communication between clinicians to support patient care coordination.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Clinical & Coding Specifications

    Clinical Context

    A primary care physician or treating specialist spends 30 minutes communicating detailed patient information to a consulting clinician using phone, secure text, secure email, or other electronic media. Typical scenario: a 68-year-old patient with congestive heart failure (CHF) and worsening dyspnea is evaluated in primary care; the treating physician reviews recent vitals, medication list, recent BNP, chest x-ray report, and clinical status, then discusses the case with a cardiologist by secure telephone to determine whether urgent cardiology input or outpatient follow-up is needed. The treating physician documents the 30-minute consultative exchange in the medical record, including data reviewed, recommendations communicated, and plan for follow-up. Typical workflow includes chart review, synthesizing clinical information, initiating and conducting the electronic consultation, and documenting time and content in the medical record prior to billing. Typical site of service is an outpatient office, clinic, or other non-facility setting where the treating clinician has access to the patient’s record; electronic communication can occur across settings (clinic to consultant office, clinic to hospital-based consultant) using phone, secure messaging, or telehealth platforms.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99446Interprofessional telephone/Internet assessment and management service provided by a consulting physician, 5-10 minutes of medical consultative discussion and reviewUsed for shorter interprofessional consults; 99452 covers the treating physician’s time whereas 99446 is the consultant’s equivalent for brief consults.
    99451Interprofessional telephone/Internet assessment and management service provided by a consultative physician, 5 minutes or more of medical consultative timeRelated consultant-side reporting when the consultant documents review and recommendations; complements the treating clinician’s 99452 report.
    99457Remote evaluation of recorded video and/or images submitted by an established patient, including interpretation and report, 20 minutes or moreMay occur in workflows involving asynchronous review of patient-generated data alongside the interprofessional exchange.
    99421Online digital evaluation and management service, for an established patient, 5-10 minutesMay be used for patient-to-practitioner secure messaging that supplements the interprofessional communication.
    99453Remote monitoring setup and patient education on use of equipmentOften performed before telemonitoring data are reviewed and discussed during an interprofessional consult such as 99452.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    93Modifier 93 denotes that a billed service was delivered synchronously via audio-only telecommunications (real-time telephone or other audio-only system). The AMA added modifier 93 in CPT Appendix A…- When to use: Apply modifier -93 when a synchronous, real-time, two-way patient–provider encounter is conducted entirely via audio-only (telephone or other real-time interactive audio-only…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207R00000X
    208D00000X
    207L00000X
    207RC0000X
    2084P0800X
    385HR2050X
    2081P0004X
    207LH0002X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-99450-INSURANCE-ELIGIBILITY-BASIC-EXAM

    CPT 99450: Basic Medical Exam for Insurance Qualification

    CPT-99451-INTERPROFESSIONAL-REMOTE-CONSULTATION-WRITTEN-REPORT

    CPT 99451: Interprofessional Telephone/Internet/EHR Consult, ≥5 Minutes

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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