2025 CPT code 99443
Effective Date: N/A Evaluation and Management - Non-Face-to-Face Services Feed
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.
Modifiers may be applicable.
The telephone service must be medically necessary and appropriate for the patient's condition.
In simple words: This code covers a 21-30 minute phone call between a doctor or other qualified healthcare professional and an established patient (or their parent/guardian) to discuss a medical issue. The call can't be related to a visit within the last 7 days and can't result in an appointment within the next 24 hours.
This code represents a telephone-based evaluation and management (E/M) service provided by a physician or other qualified healthcare professional to an established patient, their parent, or guardian. The service involves 21-30 minutes of medical discussion. It cannot originate from a related E/M service provided within the previous 7 days, nor can it lead to an E/M service or procedure within the next 24 hours or soonest available appointment.
Example 1: An established patient calls their physician with a new complaint unrelated to any recent visits. During the 25-minute call, the physician gathers information about the symptoms, reviews the patient's medications, and provides medical advice. No appointment is scheduled., A parent calls their child's established pediatrician about a concerning rash. The pediatrician spends 22 minutes discussing the rash's appearance, the child's other symptoms, and potential treatment options. The pediatrician advises the parent to monitor the rash and call back if it worsens., A guardian of an established patient calls the patient's physician to discuss concerns about the patient's medication side effects. The physician spends 28 minutes reviewing the medication list, discussing the side effects, and adjusting the medication dosage.
Documentation must include the total time spent on the call, the content of the medical discussion, and the medical decision-making process.
** As of December 10, 2024, information on the payment status, historical fee schedule, NCCI edits, and modifier TC rules is not available from the provided sources.
- Specialties:May apply to various specialties depending on the nature of the call.
- Place of Service:Telehealth Provided Other than in Patient’s Home, Office