2025 CPT code 99485
(Active) Effective Date: N/A Revision Date: N/A Supervision - Pediatric Critical Care Patient Transport Evaluation and Management Feed
Supervision by a control physician of interfacility transport care of a critically ill or injured pediatric patient (≤24 months) for the first 30 minutes, including two-way communication with the transport team.
Modifiers may be applicable depending on the specific circumstances of the transport. Consult the CPT manual and payer guidelines for specific modifier usage.
Medical necessity for code 99485 is established by the critical illness or injury of the pediatric patient requiring specialized transport.The patient's condition must necessitate the level of care and supervision provided by the control physician.
The control physician's role involves directing the transport services, providing treatment advice to the transport team, interpreting data received from the team, and preparing a report. They are responsible for the overall clinical care of the patient during the transport, but do not perform hands-on care themselves.
- Evaluation and Management
- Evaluation and Management > Inpatient Neonatal Intensive Care Services and Pediatric and Neonatal Critical Care Services
In simple words: This code covers the doctor's supervision of a critically ill or injured baby's (under 2) move between hospitals.The doctor talks to the transport team before, during, and after the move, looking at the baby's information and giving advice. This code is for the first 30 minutes of this supervision.
This CPT code reports the control physician's non-face-to-face supervision of interfacility transport for a critically ill or injured pediatric patient 24 months of age or younger.It encompasses two-way communication with the transport team before transport, at the referring facility, and during transport to the receiving facility.The supervision includes data interpretation and report generation, and advice for treatment to the transport team.The code covers the first 30 minutes of this supervision.This code is not reported together with codes 99466 and 99467 for the same patient by the same physician.Services provided by the transport team are not included.
Example 1: A 6-month-old infant with respiratory distress is being transported from a rural hospital to a tertiary care center. The control physician provides continuous supervision via two-way communication with the transport team for the initial 30 minutes of transport, interpreting data and offering guidance., A 1-year-old child involved in a motor vehicle accident requires interfacility transfer to a pediatric trauma center. The control physician oversees the transport, communicating with the transport team for the first 30 minutes and reviewing vital signs, lab results, and other patient information relayed by the team., A premature infant needs transfer to a neonatal intensive care unit (NICU) from a birthing center. The control physician coordinates care during the first 30 minutes of the transport, maintaining two-way communication, providing support and guidance to the transport team for the safe and effective transfer of the fragile neonate.
Detailed documentation should include the patient's age, clinical condition, date and time of the transport, the duration of the physician's supervision (including start and end times), all communication with the transport team (including details of advice and interpretations), and any relevant patient data reviewed.The physician should specify the reason for the interfacility transport and document the patient’s condition before, during, and after the transport.
** The physician providing supervision must be a qualified physician specializing in pediatric critical care or neonatology.
- Revenue Code: M2C (Hospital Visit - Critical Care)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Neonatology, Pediatric Critical Care Medicine
- Place of Service:Office, Hospital, Ambulatory Surgical Center, Other Place of Service (depending on the location of the physician providing supervision)