2025 CPT code 99441

Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian; 5-10 minutes of medical discussion.

If the telephone service ends with a decision to see the patient within 24 hours or next available urgent visit appointment, this code is not reported. The encounter is considered part of the preservice work of the subsequent E/M service. If the telephone call refers to an E/M service performed within the previous seven days or within the postoperative period of a previously completed procedure, then the service is considered part of that previous E/M service or procedure.

Modifier 93 may be applicable for synchronous telemedicine service rendered via telephone.

The telephone service must be medically necessary and not simply for administrative purposes or routine follow-up that could be handled by other staff.

IMPORTANT For telephone services provided by a qualified nonphysician who may not report evaluation and management services (e.g., speech-language pathologists, physical therapists, occupational therapists, social workers, dietitians), see 98966-98968. Do not report 99441-99443 if 99421-99423 have been reported by the same provider in the previous seven days for the same problem.

In simple words: A doctor or other qualified healthcare professional provides a 5–10-minute phone consultation to an established patient, their parent, or guardian. This service isn't related to a recent visit or scheduled procedure.

Telephone evaluation and management service provided by a physician or other qualified health care professional to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.

Example 1: An established patient calls their physician with a new complaint of a cough and sore throat. The physician speaks with the patient for 7 minutes, takes a brief history, and recommends over-the-counter medication.The call does not lead to an appointment within 24 hours., A parent of an established pediatric patient calls the physician concerned about their child's fever. The physician talks to the parent for 5 minutes, obtains a brief history, and advises on how to manage the fever at home.This does not result in an appointment within the next 24 hours., A guardian of an established patient calls the physician to discuss the patient's medication refills. The physician spends 9 minutes reviewing the medication list with the guardian and authorizes refills. There is no related visit or procedure scheduled within 24 hours.

Documentation should include the total time spent on the telephone providing medical discussion, the content of the discussion, and the medical decision-making process.

** As of December 1st, 2024, CMS policies regarding telephone E/M services may have changed. It's important to verify current coverage and coding guidelines with payers. Private payers' policies on telehealth services vary, so it's always recommended to check with individual payers for their specific requirements.

  • Specialties:This code can be used by various specialties, including primary care, internal medicine, pediatrics, and other specialties that provide telephone consultations.
  • Place of Service:Office, Outpatient Hospital, or Telehealth Provided in Patient's Home
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