What documentation is needed for 99211?
Unlike other E/M codes, CPT 99211 does not have any documentation requirements for the history, physical exam or complexity of medical decision making, however, supporting documentation in the patient record is required.
What qualifies for a 99212?
CPT® code 99212: Established patient office or other outpatient visit, 10-19 minutes.
What is a 99211 visit?
CPT defines this code as an “office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician.” It further states that the presenting problems are usually minimal, and typically five minutes are spent performing or supervising these services.
Can a nurse bill for 99211?
KEY POINTS: Physicians generally should not use a 99211 code for their own services, but it may be appropriate for office services performed by a nurse. To support the 99211 code for a nursing visit, a practice must have sufficient documentation.
What Does Medicare pay for a 99212?
Procedure Code 99212 Reimbursement Rates – Medicare
| CPT Code | Service Time | Rate |
|---|---|---|
| 99212 | 10 minutes | $46.13 |
| 99213 | 15 minutes | $68.10 |
| 99214 | 25 minutes | $110.43 |
| 99215 | 40 minutes | $148.33 |
Can a nurse visit be billed as a 99212?
In most cases, the visit would be a level one new patient visit (99201), level two established patient visit (99212), or nurse visit (99211), since only one body area is examined, and the history and/or medical decision-making are straightforward.
Is 99212 covered by Medicare?
Some insurance companies only pay 15% over the Medicaid rate in their state, whereas others pay 45%, 60%, 80%, 85% on top of their state’s medicaid rate….99212 Commercial Insurance Reimbursement Rates According to Medicare.
| CPT Code | Service Time | Rate |
|---|---|---|
| 99212 | 10 minutes | $90 |
| 99213 | 15 minutes | $90 |
| 99214 | 25 minutes | $90 |
Can a medical assistant bill a 99212?
The requirements for a 99212 include a problem focused history, a problem focused exam, and straightforward medical decision making. While the MA’s can take the history, the only person medically qualified to do an exam or any medical decision making is a provider.
Who qualifies to charge for a 99211?
You use 99211 if clinical staff members perform the face-to-face visit under the supervision of the physician or other qualified healthcare professional. A shared or split visit is when a physician and one or more other qualified healthcare professionals perform the face-to-face and non-face-to-face work for the E/M visit.
What is the difference of a 99202 and 99212?
What is the difference betweenpsychiatry codes 99212 and 99202? Psychiatry codes 99212 through 99215 and 99202 through 99205 are differentiated by clients being new or established. Unlike 99212-99215, 99202-99205 describe newly established clients being seen for evaluation and management services. What is the range of CPT code 99211?
When to use 99211?
Use code 99211 when the symptoms are mild and an ancillary of the physician is evaluating and managing. The primary use of 99211 CPT code is for staff in relation to the physician, not the physician themselves.
When to use 99212?
It is a physician visit, that the physician is allowed to charge when qualified ancillary personnel are with the patient (while the physician is on site) carrying out orders from a previous visit and no other CPT code is available such as repeat BP checks.