CPT Code
Services
Description
77427
Radiation management
It is reported once for every five fractions or treatment sessions regardless of the actual time period in which the services are furnished. The services need not be furnished on consecutive days.
90853
Group psychotherapy
Group psychotherapy including interpersonal interactions and support with several patients; typically 45 to 60 minutes in length.
90953
End-stage renal disease, one visit per month, ages 2 and younger
End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, etc.
90959
End-stage renal disease, one visit per month, ages 12-19
End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth
90962
End-stage renal disease, one visit per month, ages 20 and older
With 1 face-to-face physician visit per month
92057
Speech/hearing therapy
Treatment of speech, language, voice, communication, and/or auditory processing disorder, individual
92521
Evaluation of speech fluency
Evaluation of speech fluency (e.g., stuttering, cluttering)
92522
Evaluation speech production
Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
92523
Speech sound language comprehension
Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
92524
Behavioral quality voice analysis
Behavioral and qualitative analysis of voice and resonance.
96130
Psychological test Evaluation Phys/qhp 1st
Psychological testing evaluation services by a physician or other qualified healthcare professional, including the integration of patient data, interpretation of standardized test results and clinical data
96131
Psychological test evaluation phys/qhp ea
Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour
96132
Neuropsychological testing evaluation phys/qhp 1st
Neuropsychological testing evaluation services by physician or other qualified healthcare professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour
96133
Neuropsychological testing evaluation phys/qhp ea
The first hour of neuropsychological evaluation is billed using 96132 and each additional hour needed to complete the service is billed with code 96133
96136
Psychological and neurological testing phy/qhp 1s
Psychological or neuropsychological test administration/scoring by physician or other qualified healthcare professional, two or more tests, any method; first 30 minutes
96137
Psychological and neurological testing phy/qhp ea
Similar to 96136. This code is used for each additional hour.
96138
Psychological and neurological tech phy/qhp ea
Psychological or neuropsychological test administration/scoring by technician, two or more tests, any method; first 30 minutes
96139
Psychological and neurological testing tech ea
Similar to 96138.
97110
Therapeutic exercises
Foundational, occupational therapy exercises that are designed to improve a patient’s strength, range of motion, endurance, or flexibility.
97112
Neuromuscular re-education
Specific exercises or activities performed and for what purpose, neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, and/or posture.
97116
Gait training therapy
Therapeutic procedure, one or more areas, each 15 minutes; gait training (includes stair climbing).
97161
Physical therapy evaluation
Physical therapy evaluation of low complexity, 20 min
97162
Physical therapy evaluation
Physical therapy evaluation moderate complexity, 30 min
97163
Physical therapy evaluation
Physical therapy evaluation moderate complexity, 30 min
97164
Physical therapy evaluation
Physical therapy re-evaluation establish plan care
97165
Occupational therapy evaluation
Occupational therapy evaluation low complexity, 30 min
97166
Occupational therapy evaluation
Occupational therapy evaluation moderate complexity, 45 min
97167
Occupational therapy evaluation
Occupational therapy evaluation high complexity, 60 min
97168
Occupational therapy
Occupational therapy re-evaluation establish plan care
97535
Self-care management training
Direct one-on-one supervision and instruction regarding activities of daily living related to the patient’s health and hygiene.
97750
Physical performance test
Physical performance test or measurement (e.g., musculoskeletal, functional capacity), with written report, each 15 minutes.
97755
Assistive technology assessment
This procedure is used by the provider to assess the suitability and benefits of technological interfaces that will help restore, augment, or compensate for existing functional ability in the patient.
97760
Orthotic management and training 1st en
Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes.
97761
Prosthetic training 1st enc
Prosthetic training, upper and/or lower extremities, initial prosthetic encounter, each 15 minutes
99217
Observation care discharge
This code is used to report all services provided to a patient discharged from outpatient hospital “observation status” if the discharge is on a date other than the initial date of “observation status
99218
Initial observation care
The first visit of the patient’s admission for outpatient hospital observation care by the Admitting/Supervising Physician or Other Qualified Healthcare Professional. Typically, 30 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99219
Initial observation care
Similar to 99218 but, 50 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99220
Initial observation care
Similar to 99218 but, 70 minutes are spent at the bedside and on the patient’s hospital floor or unit.
99221
Initial hospital care
Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician.
99222
Initial hospital care
Similar to 99221
99223
Initial hospital care
Similar to 99221
99234
Observation/hospital same date
Observation or inpatient care, are used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.
99235
Observation/hospital same date
Observation or inpatient care is used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.
99236
Observation/hospital same date
Observation or inpatient care is used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.
99238
Hospital discharge day
Used when time spent is less than 30 minutes on the discharge process in face-to-face evaluation.
99239
Hospital discharge day
Used when time spent is greater than 30 minutes on the discharge process in face-to-face evaluation.
99281
Emergency department visit
Requires these 3 key components: A problem-focused history; A problem-focused examination; and Straightforward medical decision-making. Usually, the presenting problem(s) are self-limited or minor.
99282
Emergency department visit
Requires these 3 key components: An expanded problem-focused history; An expanded problem-focused examination; and Medical decision-making of low complexity. Usually, the presenting problem(s) are of low to moderate severity.
99283
Emergency department visit
Requires these 3 key components: An expanded problem-focused history; An expanded problem-focused examination; and Medical decision-making of moderate complexity. Usually, the presenting problem(s) are of moderate severity.
99284
Emergency department visit
Requires these 3 key components: A detailed history; A detailed examination; and Medical decision-making of moderate complexity. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.
99285
Emergency department visit
Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.
99291
Critical care first hour
It is used to report the services of a physician providing full attention to a critically ill or critically injured patient from 30-74 minutes on a given date
99292
Critical care additional 30 mins
Code 99292 (critical care, each additional 30 minutes) is used to report additional block(s) of time, of up to 30 minutes each beyond the first 74 minutes of critical care.
99304
Nursing facility care initial
The problem(s) requiring admission are of low severity. Typically, 25 minutes are spent at the bedside and on the patient’s facility floor or unit.
99305
Nursing facility care initial
The problem(s) requiring admission are of moderate severity. Typically, 35 minutes are spent at the bedside and on the patient’s facility floor or unit.
99306
Nursing facility care initial
The problem(s) requiring admission are of high severity. Typically, 45 minutes are spent at the bedside and on the patient’s facility floor or unit.
99315
Nursing facility discharge day
99315 is for discharge day management 30 minutes or less
99316
Nursing facility discharge day
This code is for discharge day management over 30 minutes
99327
Domiciliary or rest home visit new patient
Domiciliary or rest home visit for the evaluation and management of a new patient. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99328
Domiciliary or rest home visit new patient
Code used for Evaluation and Management / Domiciliary, rest home (boarding home) or custodial care services. The general guidance for this code is that it is used for new patient assisted living visits, typically 75 minutes.
99334
Domiciliary or rest home visit established patient
This code 99334 is used to reflect the domiciliary or rest home visit for the E/M of an established patient
99335
Domiciliary or rest home visit established patient
Similar to 99334
99336
Domiciliary or rest home visit established patient
Similar to 99334
99337
Domiciliary or rest home visit established patient
Domiciliary or rest home visit for the evaluation and management of an established patient. Usually, the presenting problem(s) are moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family
99341
Home visit new patient
Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 1 new patient home visit.
99342
Home visit new patient
Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 2 new patient home visit.
99343
Home visit new patient
Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 3 new patient home visit.
99344
Home visit new patient
Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 4 new patient home visit.
99345
Home visit new patient
Home services are provided in a private residence. A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home.Level 5 new patient home visit.
99347
Home visit established patient
Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components. A problem-focused interval history; a problem-focused examination; and straightforward medical decision making. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99348
Home visit established patient
Similar to CPT Code 99348. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99349
Home visit established patient
Similar to CPT Code 99348. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99350
Home visit established patient
Similar to CPT Code 99348. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99468
Neonatal critical care initial
Services of directing the inpatient care of a critically ill neonate or infant 28 days or younger.
99469
Neonatal critical care initial
Services of directing the inpatient care of a critically ill neonate or infant 28 days or younger.
99471
Pediatric critical care initial
Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
99472
Pediatric critical care initial
Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age
99473
Self-measurement of blood pressure at home education/training
Code 99473 represents the work of training the patient and calibrating the device,
99475
Pediatric critical care ages 2-5 initial
Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age
99476
Pediatric critical care ages 2-5 subsequent
Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age
99477
Initial day of hospital care for neonatal care
Initial hospital care of the neonate (28 days or younger) who is not critically ill but requires intensive observation, frequent interventions, and other intensive care services.
99478
Ic low-birthweight infant
Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant( < 1500 gm)
99479
Ic low-birthweight infant < 1500-2500 g subsequent
Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant( 1500 gm-2500g)
99480
Ic infant pbw 2501-5000 g subsequent
Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant(2501g-5000g)
99483
Assessment and care plan cognitive impairment
Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home