2025 CPT code 99464
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Management - Delivery/Birthing Room Attendance and Resuscitation Services Evaluation and Management > Delivery/Birthing Room Attendance and Resuscitation Services Feed
Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of the newborn.
Modifiers 25, 80, 81, 82, may apply depending on the circumstances.
Medical necessity is established by the presence of anticipated complications during delivery, such as fetal distress or other high-risk conditions requiring immediate intervention by an additional qualified healthcare professional.
The backup provider assists the primary provider in managing fetal distress or other anticipated complications with the newborn.
- Evaluation and Management > Delivery/Birthing Room Attendance and Resuscitation Services
- Evaluation and Management
In simple words: This code covers a doctor or other qualified healthcare professional being present at a baby's birth because the delivering doctor requested their help.They're there for the birth and to help the baby right after, especially if there were problems during pregnancy or birth.The helper must be in the delivery room for the birth; if they miss it, a different code is used.
CPT code 99464 describes the services rendered by a physician or other qualified healthcare professional who is present during a delivery at the explicit request of the delivering physician.This includes attendance during the delivery itself and the immediate stabilization of the newborn following birth. This is typically indicated when fetal distress or other anticipated complications are present. The provider must be physically present in the delivery room during the birth;missing the delivery, regardless of the time difference, prevents the use of this code.If the provider was not present, code 99460 (Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant) should be used instead.
Example 1: A high-risk pregnancy with anticipated fetal distress leads the obstetrician to request a neonatologist's presence during the delivery. The neonatologist uses code 99464 for attendance and initial stabilization., A mother with a history of pre-eclampsia delivers a baby prematurely.An additional physician is present for this high-risk delivery to provide immediate stabilization of the infant, and 99464 is used., During a twin delivery, one of the twins shows signs of respiratory distress at birth. The attending obstetrician requests the assistance of a pediatrician present in the delivery room.The pediatrician uses 99464 to bill for their services.
Documentation should include the request for the additional provider's services by the delivering physician or qualified healthcare professional, the provider's presence during the delivery, the newborn's immediate stabilization,and any complications encountered.The medical record must clearly demonstrate medical necessity.
** Standby services are not reported under CPT guidelines.Code 99360 (standby service) may be reported separately with codes 99460 and 99465, but not with 99464. Payment policies may vary regarding the allowance for 99360 in conjunction with a cesarean section or high-risk delivery.
- Revenue Code: M6 (Consultations)
- Payment Status: Active
- Specialties:Obstetrics, Neonatology, Pediatrics
- Place of Service:Inpatient Hospital, Birthing Center