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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 HCPCS code G0463

Hospital outpatient clinic visit for assessment and management of a patient.

2025 CPT code 99437

Chronic care management services, each additional 30 minutes by a physician or other qualified healthcare professional, per calendar month (List separately in addition to code for primary procedure).

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 HCPCS code M1009

Discharge/discontinuation of the episode of care documented in the medical record for patients 14 years of age and older with knee impairments.

2025 CPT code 99443

Telephone evaluation and management service provided by a physician or other qualified healthcare professional to an established patient, parent, or guardian; 21-30 minutes of medical discussion.

2025 CPT code 1000F

Tobacco use assessed.

2025 CPT code 3066F

Documentation of treatment for nephropathy (e.g., patient receiving dialysis, being treated for ESRD, CRF, ARF, or renal insufficiency, any visit to a nephrologist).

2025 CPT code 99374

Supervision of a home health agency patient (patient not present) requiring complex care, involving care plan development/revision, report reviews, communication with healthcare professionals, and treatment adjustments; 15-29 minutes per month.

2025 CPT code 99215

Office or other outpatient visit for an established patient; requires medically appropriate history and/or examination and high-level medical decision-making; when using total time, 40 minutes must be met or exceeded.

2025 CPT code 99315

Nursing facility discharge management; 30 minutes or less total time on the date of the encounter.

2025 CPT code 99381

Initial comprehensive preventive medicine evaluation and management for a new infant patient (under 1 year).

2025 HCPCS code G2211

Add-on code for increased complexity of office/outpatient E/M visits reflecting ongoing care and patient-provider relationship.

2025 HCPCS code G2004

Comprehensive (60-minute) in-home visit for a new patient within 90 days of hospital discharge; limited to Medicare-approved CMMI models.

2025 CPT code 99243

Office or other outpatient consultation; low medical decision making or at least 30 minutes of total time.

2025 CPT code 99242

Office or other outpatient consultation; straightforward medical decision making or at least 20 minutes of total time.

2025 HCPCS code G0466

FQHC visit for a new patient; a medically necessary, face-to-face encounter.

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.

2025 CPT code 99441

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; 5-10 minutes of medical discussion.

2025 CPT code 99450

Basic life and/or disability examination, including height, weight, and blood pressure measurement; medical history; blood and/or urine sample collection; and documentation.

2025 CPT code 99457

Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes.

2025 CPT code 99448

Interprofessional telephone/internet/electronic health record consultation provided by a consultant, including a verbal and written report, lasting 21-30 minutes.

2025 CPT code 99449

Interprofessional telephone/internet/electronic health record consultation by a consultant, including a verbal and written report, lasting 31 minutes or more.

2025 CPT code 99465

Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output.

2025 CPT code 99451

Interprofessional consultation via telephone, internet, or EHR with a written report, lasting 5 minutes or more.

2025 CPT code 99468

Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger.

2025 CPT code 99469

Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger.

2025 CPT code 99480

Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2501-5000 grams).

2025 CPT code 99477

Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services.

2025 CPT code 99463

Initial hospital or birthing center care, per day, for the evaluation and management of a normal newborn infant admitted and discharged on the same date.

2025 CPT code 99478

Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1500 grams).

2025 CPT code 99487

Complex chronic care management services: at least 60 minutes of clinical staff time directed by a physician or other qualified healthcare professional, per calendar month, for patients with multiple (two or more) chronic conditions.

2025 CPT code 99484

Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month.

2025 CPT code 99493

Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities.

2025 CPT code 99492

Initial psychiatric collaborative care management, first 70 minutes in the first 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 99486

Supervision by a control physician of interfacility transport care of a critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with the transport team before transport, at the referring facility, and during transport, including data interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure).

2025 CPT code 99495

Transitional care management services including communication with the patient/caregiver within two business days of discharge, moderate medical decision making, and a face-to-face visit within 14 calendar days of discharge.

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.