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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 92526

Treatment of swallowing dysfunction and/or oral function for feeding.

2025 CPT code 1400F

Parkinson's disease diagnosis reviewed.

2025 CPT code 99489

This code covers additional time spent by clinical staff, under the direction of a physician or other qualified healthcare professional, for complex chronic care management services beyond the first hour.

2025 CPT code 2015F

Assessment of asthma impairment.

2025 CPT code 1070F

Alarm symptoms (involuntary weight loss, dysphagia, or gastrointestinal bleeding) assessed; none present (GERD).

2025 CPT code 1003F

Level of activity assessed. This code is used for performance measurement and is not a substitute for Category I codes.

2025 CPT code 5010F

Documents communication of dilated macular or fundus exam findings to the physician managing diabetes care.

2025 CPT code 4322F

Caregiver provided education and referral to additional resources for support, related to dementia.

2025 CPT code 2000F

Blood pressure measured (CKD)(DM)

2025 CPT code 1018F

Dyspnea assessed, not present (COPD).

2025 CPT code 1006F

Assessment of osteoarthritis symptoms and functional status, possibly using standardized scales like the SF-36 or AAOS Hip & Knee Questionnaire.Report this code when osteoarthritis is addressed during the patient encounter.

2025 CPT code 2030F

Hydration status documented, normally hydrated.

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 HCPCS code G9489

Remote E/M visit for an established patient (40 minutes), limited to Medicare CMS Innovation Center Demonstration Projects.

2025 HCPCS code G0467

This HCPCS code represents a medically necessary, face-to-face visit between an established patient and an FQHC practitioner, encompassing bundled Medicare-covered services.

2025 HCPCS code G2014

Limited (30-minute) care plan oversight for post-discharge patients within 90 days of inpatient discharge, restricted to providers in Medicare-approved CMMI models.

2025 HCPCS code G9484

Remote in-home visit for a new patient's evaluation and management within a Medicare-approved CMS Innovation Center demonstration project, requiring a comprehensive history, examination, and moderately complex medical decision-making.

2025 HCPCS code G9487

Telehealth E/M visit for established patient post-discharge from a procedure covered under the Medicare CMS Innovation Center Demonstration Project, lasting approximately 15 minutes.

2025 CPT code 99460

Initial hospital or birthing center care, per day, for evaluation and management of a normal newborn infant.

2025 CPT code 99483

Assessment and care planning for a patient with cognitive impairment, including a comprehensive evaluation, functional assessment, medication review, and care plan development; typically requiring 60 minutes.

2025 CPT code 99459

Pelvic examination, add-on code to be reported with other E/M services.

2025 CPT code 99475

Initial inpatient pediatric critical care, per day, for a critically ill child aged 2-5 years.

2025 CPT code 1119F

Initial evaluation for a condition related to a program measure (Hepatitis C, Epilepsy, or Distal Symmetric Polyneuropathy).

2025 CPT code 0509F

Documents the presence of a documented plan of care for urinary incontinence.

2025 HCPCS code G0463

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

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 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.

2025 CPT code 3117F

Heart failure disease-specific structured assessment tool completed.

2025 CPT code 1181F

Neuropsychiatric symptoms assessed and results reviewed.

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