Summary & Overview
CPT 99467: In-Person Care for Critically Ill Infant During Transport
CPT code 99467 represents in-person clinical accompaniment and care of a critically ill or injured child aged two years or younger during interfacility transport. This code documents a specialized, high-acuity service provided by trained clinicians to maintain patient stability and deliver necessary interventions while moving between facilities. Nationally, accurate use of this code supports consistent capture of resource-intensive pediatric transport services and informs payment and quality measurement for neonatal and infant critical care.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the service, the typical site of service, and the types of benchmarks and policy topics commonly associated with transport-accompaniment codes. The publication outlines reimbursement and utilization benchmarks, relevant policy updates affecting transport and critical-care coding, and operational considerations for documenting time and interventions during transport.
The content provides clarity on how CPT code 99467 fits within pediatric critical care workflows, what aspects of service it captures, and where stakeholders typically focus when assessing coverage, coding accuracy, and program design. Data not available in the input are noted where applicable and excluded from the discussion.
Billing Code Overview
CPT code 99467 describes the in-person accompaniment and care provided by a clinician for a critically ill or injured child who is two years of age or younger during interfacility transport. This service covers hands-on clinical management, monitoring, and interventions provided while the patient is transported from one facility to another.
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Service type: Critical care/transport accompaniment
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Typical site of service: Interfacility transport between healthcare facilities (in-person, during transfer)
Clinical & Coding Specifications
Clinical Context
A critically ill 9-month-old infant with severe bronchiolitis requires transfer from a community hospital emergency department to a tertiary pediatric intensive care unit for advanced respiratory support. The attending pediatric intensivist or neonatal/pediatric transport physician accompanies the child in person on an ambulance or air transport (rotor or fixed wing) to provide continuous critical care during transfer. The workflow begins with acceptance by the receiving facility, stabilization and preparation at the sending site (airway management, IV/IO access, medication bolus, initiation of noninvasive or invasive ventilation as indicated), and handoff to the transport team. The transporting physician documents time spent accompanying the patient in transit, interventions performed (intubation, medication administration, ventilator management, hemodynamic support), and the handover at arrival to the receiving PICU team. This service is billed when the physician physically accompanies and provides critical care to a child two years of age or younger during interfacility transport, consistent with requirements for 99467.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Physician or practitioner billing for usual services | Use when the service is the provider's typical service and no unusual circumstances apply |