In simple words: A doctor visits a new patient at their home (including private homes, hotels, assisted living, etc.) for a medical check-up. The visit is lengthy (at least 75 minutes) or involves a very complex medical situation.

This CPT code represents an evaluation and management (E/M) service provided to a new patient in their home or residence.The service includes a medically appropriate history and/or examination.Code selection is based on either the level of medical decision-making (MDM), which must be high, or the total time spent on the encounter, which must be at least 75 minutes.This total time encompasses both face-to-face and non-face-to-face activities on the encounter date, excluding travel time. Examples of included activities are reviewing tests, performing the exam, counseling and educating the patient or caregiver, ordering tests, communicating with other providers, documenting the encounter, interpreting and communicating results, and coordinating care.The home or residence includes private residences, temporary lodging, assisted living facilities, group homes (excluding those licensed as intermediate care facilities for individuals with intellectual disabilities), custodial care facilities, or residential substance abuse treatment facilities.

Example 1: An elderly patient with multiple chronic conditions (e.g., heart failure, diabetes, hypertension) is unable to travel to the clinic. The physician performs a comprehensive home visit, reviewing the patient's medications, conducting a physical exam, ordering lab tests, and developing a care plan., A new patient with a complex neurological condition requires extensive assessment at home, including neurological examination, cognitive testing, and family interview.The physician spends over 90 minutes providing care and coordinating with specialists., A patient discharged from the hospital requires ongoing care at home due to continued instability. The physician performs an extensive home visit, reviewing the hospital discharge summary, assessing the patient's condition, and developing a home care plan. The visit necessitates substantial medical decision-making.

Detailed documentation of the history (including present illness, past medical history, family history, social history, review of systems), physical examination (including vital signs, pertinent findings), medical decision making (including problem complexity, data reviewed, risk of morbidity/mortality), and time spent (both face-to-face and non-face-to-face) are required.Supporting documentation may include lab results, imaging reports, and consultation reports.

** Travel time is not included in the total time calculation for code 99345.Accurate documentation is crucial for proper reimbursement.Ensure that all aspects of the visit are documented appropriately, including MDM or total time spent.