2025 CPT code 99442
Effective Date: N/A Evaluation and Management - Non-Face-to-Face Services Feed
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 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; 11-20 minutes of medical discussion.
Modifiers may be applicable to further specify the circumstances of the service. Refer to current CPT guidelines for appropriate modifier usage.
The medical necessity of this service must be documented and justified based on the patient's individual circumstances. It should be used for situations where a telephone consultation is sufficient to address the patient's immediate medical needs without requiring an in-person visit.
In simple words: A doctor or other qualified healthcare professional provides medical advice to an established patient, their parent, or guardian over the phone. The call lasts between 11 and 20 minutes and does not include discussions related to recent visits or upcoming appointments.
Telephone evaluation and management service provided by a physician or other qualified healthcare professional to an established patient, parent, or guardian. This service must not originate from a related E/M service provided within the previous 7 days, nor should it lead to an E/M service or procedure within the next 24 hours or soonest available appointment. The service involves 11-20 minutes of medical discussion.
Example 1: An established patient calls their physician with a new complaint of a persistent cough. The physician spends 15 minutes discussing the patient's symptoms, medical history, and current medications. The physician determines that the cough is likely due to allergies and recommends over-the-counter medication. The physician advises the patient to schedule an appointment if symptoms worsen or do not improve within a week., A parent calls their child's pediatrician concerned about their child's recent fever. The pediatrician spends 12 minutes discussing the child's symptoms, medical history, and any recent exposures to illness. The pediatrician advises the parent to monitor the child's temperature and to bring the child in for an evaluation if the fever persists or other symptoms develop., A guardian calls their elderly ward's physician to report a new skin rash. The physician spends 18 minutes discussing the rash's appearance, location, and any associated symptoms. The physician advises the guardian to apply a topical cream and to schedule an appointment for an in-person evaluation if the rash does not improve.
Documentation should include the date and time of the call, the total duration of the medical discussion, the patient's presenting complaint, the relevant medical history, the clinical decision-making process, and any recommendations or instructions provided to the patient, parent, or guardian.
- Specialties:This code can be used by various medical specialties, including primary care, pediatrics, internal medicine, and other specialties where telephone consultations are appropriate.
- Place of Service:Office, telehealth provided in patient's home, telehealth provided other than in patient's home.