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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 5200F
Consideration of referral for a neurological evaluation of appropriateness for surgical therapy for intractable epilepsy within the past 3 years.
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.
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 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 HCPCS code G0246
Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in loss of protective sensation (LOPS).
2025 CPT code 99424
Principal care management services for a single high-risk disease, encompassing care plan development, monitoring, or revision;first 30 minutes provided personally by a physician or qualified healthcare professional per calendar month.
2025 HCPCS code T1015
All-inclusive clinic visit for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
2025 CPT code 99491
Chronic care management services; first 30 minutes of physician/qualified healthcare professional time per calendar month.
2025 CPT code 99479
Subsequent intensive care, per day, for a low birth weight infant (1500-2500 grams).
2025 CPT code 99485
Supervision by a control physician of interfacility transport care of a critically ill or injured pediatric patient (≤24 months) for the first 30 minutes, including two-way communication with the transport team.
2025 CPT code 99425
Additional 30 minutes of principal care management services, personally provided by a physician or other qualified healthcare professional, for a single high-risk chronic condition lasting at least 3 months.
2025 CPT code 99496
Transitional care management services involving high-level medical decision-making, requiring a face-to-face visit within 7 days of discharge.
2025 CPT code 99385
Initial comprehensive preventive medicine evaluation and management for a new patient aged 18-39 years, including history, exam, counseling, and ordering of lab/diagnostic procedures.
2025 CPT code 99460
Initial hospital or birthing center care, per day, for evaluation and management of a normal newborn infant.
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.
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