2025 CPT code 99467
(Active) Effective Date: N/A Revision Date: N/A Critical Care - Pediatric Critical Care Patient Transport Evaluation and Management > Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services Feed
Reports each additional 30 minutes of face-to-face critical care provided to a critically ill or injured pediatric patient (≤24 months) during interfacility transport.Must be used with 99466.
Modifiers may apply depending on the specific circumstances of the transport.Consult the CPT manual and local payer guidelines.
Medical necessity is established by the critical illness or injury of the pediatric patient requiring immediate specialized care unavailable at the referring facility.The transport must be medically necessary and the physician's services must be essential for the patient's stabilization and safe transfer.
The physician provides hands-on critical care to the pediatric patient during transport, including monitoring, interpretation of data, and procedures as needed.
- Evaluation and Management > Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
- Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
In simple words: This code is for doctors who travel with and directly care for a very sick or injured baby or toddler (under 2 years old) while moving them between hospitals. It's used only if the doctor spends more than 30 minutes with the child in total. This code is added to another code (99466) to show how long the doctor provided care.
This code reports each additional 30-minute interval of direct, face-to-face critical care provided by a physician to a critically ill or injured pediatric patient who is 24 months of age or younger during transport between facilities.Face-to-face care begins when the physician assumes primary responsibility at the referring facility and ends when the receiving facility accepts responsibility. The time spent must exceed 30 minutes total for this code to be reported; it is an add-on code and requires the use of 99466 (first 30-74 minutes) for reimbursement.Services included in 99466 are not reported separately.Only time spent in direct face-to-face contact with the patient during transport should be reported. Services performed by other members of the transport team are not reported by the supervising physician.
Example 1: A neonate requires transport from a rural hospital to a tertiary care center for ECMO support. The attending neonatologist accompanies the infant during the 2-hour transport, providing continuous monitoring and management of the infant's condition.99466 and 99467 would be used to report this., A 1-year-old child sustains serious injuries in a motor vehicle accident. A pediatric surgeon travels with the child to a trauma center, providing continuous care during the hour-long transport, including managing airway, hemorrhage control and fluid resuscitation. 99466 and 99467 would be used., A 6-month-old infant is experiencing respiratory distress in a remote area. A pediatrician is dispatched to assist with the transport to a regional medical center; the transport lasts 90 minutes, during which the pediatrician manages the baby’s respiratory support, administers medications and monitors vital signs.99466 and 99467 would be reported here.
Detailed documentation is required, including the patient's age, diagnosis, the start and end times of face-to-face care, and a description of all services rendered.Medical records of the referring and receiving facilities should be referenced.
** This code is an add-on code and should only be reported with 99466.Services included in 99466 should not be reported separately.Always refer to the most current CPT guidelines and payer specific policies for accurate coding and reimbursement.
- Revenue Code: M2C (Hospital Visit - Critical Care)
- RVU: Information not provided.RVUs vary by payer and location.
- Global Days: Not applicable. This is not a global procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable. This code represents the physician's face-to-face time.
- Fee Schedule: Information not provided.Fee schedules vary by payer and location.Consult the appropriate fee schedule for the relevant time period.
- Specialties:Neonatology, Pediatric Critical Care Medicine, Emergency Medicine, Pediatric Surgery
- Place of Service:Ambulance - Land, Ambulance - Air or Water