What does CPT code 99211 mean?

Code 99211 is commonly used for services such as patient education, simple rechecks and medication reviews. Some procedures can also appropriately be reported with this code. A patient comes to the office for a blood-pressure check. If the visit was scheduled at the request of the physician, 99211 should be reported.

Is 99211 a valid CPT code in 2021?

CPT code 99211 (established patient, level 1) will remain as a reportable service.

Is 99211 a valid CPT code?

CPT® code 99211 is defined by the 2011 CPT Standard Edition manual as: “Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician. Usually, the presenting problem(s) are minimal.

What are the requirements to bill a 99211?

Six keys to coding 99211 visits

  • The patient must be established.
  • The provider-patient encounter must be face-to-face.
  • An E/M service must be provided.
  • The service must be separate from other services performed on the same day.
  • The presence of a physician is not always required.
  • No key components are required.

What services can be billed with 99211?

Proper Use of 99211 CPT® code 99211 Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional.

What is procedure code 99213?

CPT Code 99213: Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision making.

Can you still use CPT code 99201?

Based on the CPT changes, code 99201 is no longer valid for dates of service on and after January 1, 2021, as clinicians may choose the E/M visits level based on either medical decision making or time, both CPT code 99201 and 99202 previously require straightforward medical decision making, therefore the decision was …

What modifier is needed for 99211?

modifier 25
Effective for claims processed on or after March 16, 2020, we will deny reimbursement for evaluation and management (E&M) services billed with Current Procedural Terminology (CPT®) code 99211 appended with modifier 25 when billed alone or with another procedure code on the same date of service.

Can you bill 99211 for dressing change?

A. The 99211 E/M visit is a nurse visit and should only be used by medical assistant or nurse when performing services such as wound checks, dressing changes or suture removal. CPT code 99211 should never be billed for physician services.

Can you bill a 99211 with injection?

You can either bill for the 99211 plus the medications or bill for the injection plus the medications. If the nurse must only give an injection, we use the injection codes.

Who can bill for 99213?

CPT Code 99213 can be utilized for a mid-level outpatient or inpatient office visit. CPT Code 99213 is a level three code that should be used for an established patient. It cannot be used with a new patient who has no history.

How many minutes is CPT 99213?

15 minutes
99213 Reimbursement Rates: – Medicaid:

CPT Code Service Time Rate
99212 10 minutes $31.36
99213 15 minutes $43.23
99214 25 minutes $66.80
99215 40 minutes $99.95