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ALL MEDICAL CODES IN CATEGORY Evaluation and Management
2025 HCPCS code G0318
Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service.
2025 CPT code 99358
Prolonged evaluation and management service before and/or after direct patient care; first hour.
2025 CPT code 99304
Initial nursing facility care, per day, requiring a medically appropriate history and/or examination and straightforward or low level of medical decision making. Total time must be at least 25 minutes when using time for code selection.
2025 CPT code 1151F
Documentation that a patient does not have a substantial risk of death within one year.
2025 CPT code 99307
Subsequent nursing facility care, per day, requiring a medically appropriate history and/or examination and straightforward medical decision making. When using total time, 10 minutes must be met or exceeded.
2025 CPT code 1152F
Documentation of advanced disease diagnosis, goals of care prioritize comfort.
2025 HCPCS code G2002
Post-discharge new patient home visit, approximately 30 minutes, by a provider enrolled in a Medicare-approved CMMI model project, within 90 days of hospital discharge (up to nine visits allowed).
2025 CPT code 1137F
Episode of back pain lasting longer than 12 weeks (BkP).
2025 CPT code 99498
Advance care planning including the explanation and discussion of advance directives, such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure).
2025 CPT code 99458
Remote physiologic monitoring treatment management services, each additional 20 minutes of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver (List separately in addition to code for primary procedure).
2025 CPT code 1052F
Type, anatomic location, and activity all assessed (IBD).
2025 CPT code 1060F
Documentation of permanent or persistent or paroxysmal atrial fibrillation.
2025 CPT code 99461
Initial care, per day, for the evaluation and management of a normal newborn infant seen in a setting other than a hospital or birthing center.
2025 HCPCS code G0468
Federally Qualified Health Center (FQHC) visit, including an Initial Preventive Physical Exam (IPPE) or Annual Wellness Visit (AWV) with a typical bundle of Medicare-covered services.
2025 CPT code 99494
Add-on code for psychiatric collaborative care management, representing each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional.
2025 CPT code 1460F
Qualifying cardiac event/diagnosis in previous 12 months (CAD).
2025 CPT code 1450F
Symptoms improved or remained consistent with treatment goals since last assessment (HF).
2025 CPT code 1012F
This code documents the absence of angina in a patient with coronary artery disease (CAD).
2025 CPT code 1091F
Urinary incontinence characterized (e.g., frequency, volume, timing, type of symptoms, how bothersome).
2025 CPT code 1005F
Assessment of asthma symptoms, including documentation of symptom frequency or patient completion of an asthma assessment tool.
2025 CPT code 2040F
Physical examination performed on the date of the initial visit for low back pain, in accordance with specifications.
Neuropsychiatric symptoms assessed and results reviewed.
2025 CPT code 1150F
Documentation that a patient has a substantial risk of death within 1 year.
2025 CPT code 1490F
Dementia severity classified, mild (DEM).
2025 HCPCS code G8858
Audiologic evaluation for dizziness without otologic referral, lacking documented reason.
2025 CPT code 99368
Medical team conference; nonphysician qualified healthcare professional participation; 30 minutes or more; patient/family not present.
2025 CPT code 99360
Physician standby service, requiring prolonged attendance (at least 30 minutes) without direct patient contact.
2025 CPT code 99380
Supervision of a nursing facility patient (not present) requiring complex, multidisciplinary care; 30 minutes or more of care plan oversight per month.
2025 CPT code 99345
Home or residence visit for a new patient; high level medical decision making or 75+ minutes total time.
2025 CPT code 99347
Home or residence visit for an established patient; straightforward medical decision-making or at least 20 minutes of total time.
2025 CPT code 99367
Medical team conference; physician participation; 30 minutes or more; patient and/or family not present.
2025 CPT code 99238
Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter.
2025 HCPCS code G9488
Remote in-home visit for established patient evaluation and management; part of a Medicare CMS Innovation Center demonstration project.
2025 CPT code 99455
This CPT code reports a comprehensive medical evaluation for work-related or medical disability, including history, examination, diagnosis, assessment of capabilities, impairment calculation, treatment planning, and report generation.
2025 HCPCS code G2005
This HCPCS code reports each post-discharge new patient home visit (up to nine visits within 90 days of hospital discharge) lasting approximately 75 minutes, performed by a provider in a Medicare-approved CMMI model.
2025 HCPCS code S9150
Ocularist evaluation for prosthesis issues, congenital absence, or eye trauma.
2025 CPT code 99427
This code represents additional 30-minute increments of clinical staff time for principal care management services beyond the initial 30 minutes (99426), for patients with complex chronic conditions.
2025 CPT code 99375
Supervision of a home health patient (not physically present) requiring complex, multidisciplinary care; 30+ minutes of physician time per month.
2025 CPT code 99474
Remote physiologic monitoring; initial set-up and patient education on the use of equipment.
2025 CPT code 99439
Each additional 20 minutes of clinical staff time directed by a physician or other qualified healthcare professional for chronic care management, per calendar month.
2025 HCPCS code G0317
Prolonged nursing facility evaluation and management service; additional 15 minutes beyond primary service (99306 or 99310).
2025 CPT code 99473
Self-measured blood pressure using a clinically validated device; patient education/training and device calibration.
2025 CPT code 99426
Principal care management services, for a single high-risk disease, provided by clinical staff (first 30 minutes).
2025 CPT code 99490
Chronic care management services; first 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.
2025 CPT code 99499
Unlisted evaluation and management service; used when no other CPT code applies.
2025 CPT code 99453
Setup and patient education on the use of remote physiologic monitoring equipment for parameters like weight, blood pressure, and pulse oximetry.
2025 HCPCS code G0396
Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., AUDIT, DAST), and brief intervention, 15 to 30 minutes.
2025 CPT code 99429
Unlisted preventive medicine service; used when no other CPT code adequately describes the service provided.
2025 CPT code 99442
Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion.
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