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ALL MEDICAL CODES IN CATEGORY Evaluation and Management

2025 CPT code 99350

Home or residence visit for the evaluation and management of an established patient requiring a medically appropriate history and/or examination with a high level of medical decision making, or at least 60 minutes of total time spent on the date of the encounter.

2025 CPT code 99252

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

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 99406

Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes.

2025 CPT code 99308

Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.

2025 CPT code 99310

Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

2025 CPT code 5200F

Consideration of referral for a neurological evaluation of appropriateness for surgical therapy for intractable epilepsy within the past 3 years.

2025 CPT code 1151F

Documentation that a patient does not have a substantial risk of death within one year.

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 0509F

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

2025 CPT code 1060F

Documentation of permanent or persistent or paroxysmal atrial fibrillation.

2025 CPT code 99359

Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (List separately in addition to code for prolonged 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 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 99306

Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.

2025 CPT code 99394

Periodic comprehensive preventive medicine reevaluation and management of an established adolescent patient (age 12 through 17 years).

2025 CPT code 99401

Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes.

2025 CPT code 99349

Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

2025 CPT code 99305

Initial nursing facility care, requiring a medically appropriate history and/or examination, with a moderate level of medical decision making. If using total time, 35 minutes must be met or exceeded.

2025 CPT code 97164

Re-evaluation of physical therapy established plan of care.

2025 CPT code 99282

Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.

2025 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.

2025 CPT code 99213

Established patient office or other outpatient visit, requiring a medically appropriate history and/or examination and low level of medical decision making. Total time on the date of encounter must be 20 minutes or more.

2025 CPT code 99203

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

2025 CPT code 99284

Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making.

2025 CPT code 99231

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded.

2025 CPT code 99383

Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of appropriate laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years).

2025 CPT code 99235

Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 70 minutes must be met or exceeded.

2025 CPT code 99281

Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional.

2025 CPT code 99205

New patient office or outpatient visit with high-level medical decision making (MDM) or at least 60 minutes of total time spent on the date of the encounter.

2025 CPT code 99202

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.

2025 CPT code 99232

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

2025 CPT code 99233

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.

2025 CPT code 99234

Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

2025 CPT code 99254

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

2025 CPT code 99255

Inpatient or observation consultation for a new or established patient, requiring a medically appropriate history and/or examination and high-level medical decision making (MDM).If using total time, 80 minutes must be met or exceeded.

2025 CPT code 99422

Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes

2025 CPT code 99382

Initial comprehensive preventive medicine evaluation and management of a child, new patient (age 1 through 4 years).

2025 CPT code 99415

Prolonged clinical staff service during an E/M service in the office or outpatient setting, direct patient contact with physician supervision; first hour.

2025 CPT code 99421

Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes.

2025 CPT code 99416

Prolonged clinical staff service during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (List separately in addition to code for prolonged service)

2025 CPT code 99417

Prolonged outpatient evaluation and management service time with or without direct patient contact beyond the required time of the primary service, when the primary service level has been selected using total time (each 15 minutes of total time).