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Advance Care Planning

Advance Care Planning includes discussions and documentation of advance directives, surrogate decision-makers, and patient preferences for future medical care. CPT range 99497–99498 comprises two codes for advance care planning with varying time and complexity.

Care Management Services

Care Management Services encompasses coordination and management of care for patients with complex or chronic conditions, including principal, chronic, and complex chronic care management programs. CPT range 99487–99491 includes codes for complex chronic care and related management services in addition to chronic care time-based reporting.

Care Plan Oversight Services

Care Plan Oversight Services cover physician oversight of home health or hospice skilled services, including review and management of care plans. CPT range 99374–99380 contains codes for periodic and comprehensive oversight visits and related documentation.

Case Management Services

Case Management Services includes interdisciplinary medical team coordination and conferences for complex patient care needs. CPT range 99366–99368 provides codes for medical team conferences with and without face-to-face contact.

Cognitive Assessment and Care Plan Services

Cognitive Assessment and Care Plan Services cover evaluation, diagnosis, and care planning for cognitive disorders such as dementia, including development of a comprehensive care plan. CPT range 99483–99486 contains codes for cognitive assessment, care planning, and related follow-up services.

Consultations

Consultations comprise formal requests for specialist evaluation and management by consultants in office, outpatient, or inpatient settings. CPT range 99242–99255 includes office/outpatient and inpatient consultation codes for new or established patients with varying complexity.

Critical Care Services

Critical Care Services include management of critically ill or injured patients requiring high-intensity life-sustaining interventions and continuous physician involvement. CPT range 99291–99292 consists of codes for initial critical care time and subsequent critical care time reporting.

Delivery/Birthing Room Attendance and Resuscitation Services

Delivery/Birthing Room Attendance and Resuscitation Services cover attendance at delivery and immediate neonatal resuscitation by qualified providers. CPT range 99464–99465 includes codes for attendance and initial resuscitation services in the birthing setting.

Emergency Department Services

Emergency Department Services encompass evaluation and management of patients presenting to the ED for urgent or emergent conditions across triage, treatment, and disposition. CPT range 99281–99288 spans low- to high-complexity ED visits and includes a code for other emergency services.

General Behavioral Health Integration Care Management

General Behavioral Health Integration Care Management involves integration of behavioral health into primary care through care coordination, population management, and psychiatric support. CPT range 99484–99484 is a single code addressing generalized behavioral health integration care management.

Home or Residence Services

Home or Residence Services include medical evaluations and management provided in the patient’s home or other residence for new and established patients. CPT range 99341–99350 covers home visits with separate code sets for new versus established patients.

Hospital Inpatient and Observation Care Services

Hospital Inpatient and Observation Care Services cover initial, subsequent, admission, discharge, and observation care provided to hospitalized patients. CPT range 99221–99239 includes initial and subsequent inpatient services, observation care, and inpatient consultations and discharge codes.

Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services

Inpatient Neonatal Intensive Care and Pediatric Critical Care Services include intensive care, transport, and daily management for neonatal and pediatric critical patients. CPT range 99466–99480 covers neonatal/pediatric critical care time, transport, and intensive care initiation and follow-up codes.

Newborn Care Services

Newborn Care Services cover initial and subsequent hospital care of healthy newborns, including routine assessment and counseling of caregivers. CPT range 99460–99463 includes codes for hospital newborn care spanning initial visits and follow-up.

Non-Face-to-Face Services

Non-Face-to-Face Services encompass digital, remote, telephone, and online evaluation and management activities performed without in-person contact. CPT range 99437–99449 includes telephone services, online digital E/M, interprofessional consultations, and remote physiologic monitoring codes.

Nursing Facility Services

Nursing Facility Services include initial, subsequent, discharge, and periodic care provided to residents of nursing facilities and custodial settings. CPT range 99304–99316 spans initial and established nursing facility visits as well as discharge services.

Office or Other Outpatient Services

Office or Other Outpatient Services cover evaluation and management visits in office, clinic, and other outpatient settings for new and established patients. CPT range 99202–99215 includes new patient codes 99202–99205 and established patient codes 99211–99215 across levels of complexity.

Other Evaluation and Management Services

Other Evaluation and Management Services captures miscellaneous E/M procedures and unlisted evaluation services not classified elsewhere. CPT range 99499–99499 is a single unlisted or miscellaneous E/M code used for services without specific CPT codes.

Preventive Medicine Services

Preventive Medicine Services include periodic health examinations, age-specific preventive counseling, and well visits for new and established patients. CPT range 99381–99429 contains preventive visit codes for various ages plus additional counseling and group preventive services.

Prolonged Services

Prolonged Services address extended physician or clinical staff time beyond typical E/M encounters, with and without direct patient contact. CPT range 99358–99360 includes codes for prolonged services on separate days, standby, and related prolonged time increments.

Psychiatric Collaborative Care Management Services

Psychiatric Collaborative Care Management Services describe integrated psychiatric consultation and management within primary care settings with psychiatric caseload oversight. CPT range 99492–99494 includes initial and ongoing psychiatric collaborative care management codes for team-based behavioral health integration.

Special Evaluation and Management Services

Special Evaluation and Management Services include work-related, disability, and other nonroutine E/M evaluations and performance of specialized assessments. CPT range 99450–99459 covers basic life/disability evaluations and work-related or medical disability evaluation services.

Telemedicine Evaluation and Management Services

Telemedicine Evaluation and Management Services comprise synchronous audio/video, audio-only, and brief virtual check-ins for evaluation and management via telecommunication technology. CPT range 98000–98016 spans codes for audio-video telemedicine, audio-only services, and virtual check-ins.

Transitional Care Management Services

Transitional Care Management Services cover post-discharge communication and coordination to support transitions from hospital to home or other settings. CPT range 99495–99496 includes two codes differentiated by timeliness and complexity of post-discharge services.