2025 CPT code 99379
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Management - Care Plan Oversight Services Evaluation and Management Feed
Supervision of a nursing facility patient (not present) requiring complex, multidisciplinary care; 15-29 minutes of care plan oversight.
Modifiers may apply depending on the specific circumstances of the service.Consult the CPT manual for specific guidance on modifier usage.
Medical necessity is established when a patient in a nursing facility requires complex, multidisciplinary care involving regular care plan oversight due to the severity and complexity of their conditions.The coordination of multiple healthcare professionals and the frequent adjustments to the plan are crucial for optimal patient outcomes.
The physician or qualified non-physician provider is responsible for overseeing the patient's care plan, coordinating care with other specialists, reviewing reports and test results, and communicating with the patient's family or caregivers.
In simple words: This code covers the doctor's time spent managing a patient's care in a nursing home when the doctor is not physically with the patient.It includes planning, reviewing reports, communicating with other healthcare providers, and adjusting the treatment plan, all taking 15-29 minutes in a month.
This CPT code represents physician supervision of a nursing facility patient who is not physically present.The service includes regular development and/or revision of care plans, review of patient status reports and related lab/diagnostic studies, communication with healthcare professionals, family, or caregivers regarding assessment or care decisions, integrating new information into the treatment plan, and adjusting medical therapy.The total time spent on these activities within a calendar month is 15-29 minutes.
Example 1: A patient with multiple chronic conditions (diabetes, heart failure, and pressure ulcers) in a nursing facility requires coordinated care from a cardiologist, dermatologist, and dietitian. The physician coordinates and oversees the care plan, spending 20 minutes reviewing reports, communicating with other specialists, and adjusting the plan., A patient recovering from a stroke in a nursing facility needs ongoing physical and occupational therapy. The physician reviews progress reports, consults with therapists, and adjusts the therapy plan based on the patient's response, taking about 25 minutes total in a month., A patient with end-stage renal disease in a nursing facility requires regular dialysis and medication management. The physician reviews lab results, communicates with the nephrologist and dialysis team, and modifies the medication plan as needed, spending 15 minutes coordinating the multidisciplinary care.
Detailed documentation should include the dates and times of all activities performed, a description of the activities (e.g., review of reports, communication with other professionals, modifications to the plan), and the total time spent in the calendar month.Supporting medical records and test results should be referenced.
** For care plan oversight services provided in a rest home (e.g., assisted living facility) or home, see care management codes 99437, 99491, or principal care management codes 99424, 99425. For hospice agency, see 99377, 99378.
- Revenue Code: Y1 (Other - Medicare Fee Schedule)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Internal Medicine, Family Medicine, Geriatrics, Cardiology, Neurology, and other specialties depending on the patient's condition.
- Place of Service:Office, Outpatient Hospital, Other Place of Service