2025 CPT code 99360
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Management - Prolonged Services Evaluation and Management Feed
Physician standby service, requiring prolonged attendance (at least 30 minutes) without direct patient contact.
Modifiers may be applicable depending on the circumstances.Consult the current CPT manual and payer guidelines.
Medical necessity is established by the documented need for the physician's immediate availability based on patient risk or clinical circumstances as determined by the requesting physician or healthcare provider.
The physician or qualified healthcare professional remains available for immediate patient care but does not provide direct patient care during the standby period.This responsibility includes being present and immediately responsive to the needs of another physician or healthcare professional.
In simple words: This code is for a doctor or healthcare professional who is on standby for at least 30 minutes, ready to help if needed, but not directly seeing or treating the patient during that time.They cannot see other patients while on standby.
CPT code 99360 reports physician or qualified healthcare professional standby services requested by another individual.This involves prolonged attendance (minimum 30 minutes) without direct patient contact.No care is provided to other patients during this time.This code does not apply to proctoring or if standby ends with a procedure covered by a surgical package.Each 30-minute block of standby time is reported separately. Standby time less than 30 minutes is not separately billable.
Example 1: A surgeon requests anesthesia standby during a complex procedure. The anesthesiologist remains available for 30 minutes, but no services are needed. Code 99360 is reported for that 30 minutes of standby., An obstetrician is on standby for a high-risk delivery. The obstetrician is available for 60 minutes; 99360 is reported twice (two 30-minute blocks)., A pathologist is on standby for a rapid frozen section analysis during a surgical procedure. The pathologist is available for 45 minutes; 99360 is reported once (only one 30-minute block).
Detailed documentation should specify the reason for standby, the duration of standby time in 30-minute increments, confirmation that no patient care was rendered during standby, and the identity of the requesting physician or healthcare provider.Note that time spent proctoring another individual cannot be billed with 99360.
** This code should only be reported when the physician or qualified healthcare professional is exclusively on standby and provides no care or service to any patients during the reported time.Always adhere to payer-specific guidelines and local coding conventions.Incomplete documentation may lead to claim denials.
- Revenue Code: Y2 (OTHER - NON-MEDICARE FEE SCHEDULE)
- RVU: Refer to the current year's Medicare Physician Fee Schedule for RVU values and payment rates.These values vary by geographic location and other factors.
- Payment Status: Active
- Modifier TC rule: Not applicable. Code 99360 represents professional services only.
- Fee Schedule: Consult the relevant historical Medicare Physician Fee Schedule for fee data.
- Specialties:Surgery, Anesthesiology, Obstetrics and Gynecology, Pathology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Birthing Center