2025 CPT code 99486
Supervision by a control physician of interfacility transport care of a critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with the transport team before transport, at the referring facility, and during transport, including data interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure).
Modifier 25 may be applicable if a significant, separately identifiable E/M service is provided by the same physician on the same day. Modifier 59 may be appropriate to indicate a distinct procedural service.
Medical necessity must be established for the interfacility transport, based on the patient's critical condition and the need for specialized care not available at the referring facility.Documentation must clearly support the reason for the transfer and the required level of care.
The physician acts as the control physician, providing non-face-to-face supervision of the transport team. This involves constant communication, data interpretation, and providing medical guidance during the transport.
In simple words: The doctor oversees the transfer of a very sick or injured child (2 years old or younger) between hospitals for an extra 30 minutes. They stay in contact with the transport team before, during, and after the transfer, reviewing information and creating a report. This is billed in addition to the initial supervision code.
This code reports the additional 30 minutes of non-face-to-face supervision by a control physician during interfacility transport of a critically ill or injured pediatric patient aged 24 months or younger.The supervision includes two-way communication with the transport team before, at the referring facility, and during transport, encompassing data interpretation and report preparation.This code is an add-on code to 99485 and should be reported for each additional 30-minute block of time spent in non-face-to-face supervision.
Example 1: A 20-month-old infant on a ventilator requires transport to a facility with specialized pediatric cardiac care. The control physician supervises the transport team for 1 hour and 45 minutes, providing real-time guidance and interpreting data transmitted by the team., A 1-year-old child with severe trauma needs transfer to a Level 1 trauma center. The control physician provides non-face-to-face supervision for 2 hours, communicating with the team during the complex transport process., A newborn with respiratory distress syndrome requires transport to a NICU. The transport is complicated by unstable vital signs. The control physician spends 1 hour and 15 minutes in non-face-to-face direction, managing the infant’s care remotely.
Total time spent in non-face-to-face communication with the transport team, including data review and report preparation. Documentation of the patient's critical condition and the medical necessity for interfacility transport. Details of two-way communication exchanged between the physician and the transport team.
** The “control physician” is defined as the physician directing the transport services.The patient must be 24 months of age or younger and critically ill or injured to use this code. Services provided by the specialized transport team are not reported by the control physician using this code.
- Revenue Code: M2C - HOSPITAL VISIT - CRITICAL CARE
- Specialties:Critical Care Medicine, Emergency Medicine, Neonatology, Pediatrics, Transport Medicine
- Place of Service:Ambulance - Land, Ambulance - Air or Water, Office, Facility