2025 CPT code 99377
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Management - Care Plan Oversight Services Evaluation and Management Feed
Supervision of a hospice patient (not physically present) requiring complex, multidisciplinary care; includes care plan development/revision, status report review, communication with healthcare professionals and family, and treatment plan adjustments; 15-29 minutes.
Modifiers may apply depending on the circumstances of service.Consult the CPT manual and NCCI edits for specific modifier usage.
Medical necessity is established when the patient's complex medical condition requires regular, ongoing supervision from a physician or other qualified healthcare professional to coordinate multidisciplinary care, even when direct patient contact is not necessary.The patient must be receiving hospice care, and the services must be medically appropriate and necessary for the management of their terminal illness.
The physician or qualified non-physician provider is responsible for coordinating and supervising the multidisciplinary care of a hospice patient.This includes developing and adjusting the care plan, reviewing patient status reports, communicating with other healthcare providers and the patient's family, and integrating new information into the treatment plan.
In simple words: This code covers the time a doctor or other qualified healthcare provider spends managing the care of a hospice patient without directly seeing the patient.This includes planning care, checking on the patient's progress, talking to other healthcare professionals and family members, and making adjustments to the patient's treatment plan.The doctor spends 15 to 29 minutes doing this each month.
This CPT code represents the physician's or other qualified healthcare professional's supervision of a hospice patient who is not physically present.The service encompasses the development and/or revision of care plans, review of patient status reports, review of related laboratory and other studies, communication (including telephone calls) with healthcare professionals, family members, surrogate decision-makers, or key caregivers involved in the patient's care, integration of new information into the medical treatment plan, and/or adjustment of medical therapy.The total time spent on these activities within a calendar month must be between 15 and 29 minutes.
Example 1: A 78-year-old patient with end-stage heart failure is receiving hospice care at home. The physician reviews daily updates from the hospice nurse, consults with the palliative care team on pain management strategies, and communicates with the family regarding the patient's declining condition., An oncologist is managing a 65-year-old patient with metastatic cancer receiving hospice care in a skilled nursing facility.The oncologist reviews lab results, communicates with the nursing staff and the patient's family regarding symptom management, and adjusts the medication regimen based on the patient's response to treatment., A geriatric physician coordinates care for an 85-year-old patient with Alzheimer's disease receiving hospice care at home.They review care plans with home health aides, adjust medications based on the patient's behavioral changes reported by family, and communicate with the patient's family to ensure proper emotional support.
Detailed documentation is required, including the total time spent on care plan oversight activities (15-29 minutes), specific activities performed (e.g., care plan review, communication with other healthcare professionals, family updates), and dates of service.Copies of relevant reports, lab results, and communication logs should be included.
** Only one provider may bill code 99377 for a given patient within a calendar month.This code should not be reported for supervision of patients in nursing facilities or under the care of home health agencies, unless they require recurrent supervision of therapy.This code should not be reported for time reported with certain other codes (refer to CPT guidelines for specifics).
- Revenue Code: Y1 (OTHER - MEDICARE FEE SCHEDULE)
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier does not apply to this code as it represents professional services.
- Specialties:Hospice and Palliative Medicine, Oncology, Geriatrics
- Place of Service:Office, Home, Skilled Nursing Facility, Other