| Package | us.nlm.vsac |
| Type | ValueSet |
| Id | Id |
| FHIR Version | R4 |
| Source | http://fhir.org/packages/us.nlm.vsac/https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1078.860/expansion |
| Url | http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1078.860 |
| Version | 20240308 |
| Status | active |
| Date | 2024-03-08T01:19:14-05:00 |
| Name | PIM_Ambulatory_Visits_CPTs |
| Title | PIM_Ambulatory_Visits_CPTs |
| Experimental | False |
| Realm | us |
| Authority | hl7 |
| Purpose | (Clinical Focus: Ambulatory visits),(Data Element Scope: Visit types for IM/FM (Primary Care) providers represented by CPT codes),(Inclusion Criteria: Visits for conditions that are not critical, acute, or emergent in nature),(Exclusion Criteria: None) |
No resources found
| CodeSystem | |
http://www.ama-assn.org/go/cpt  | Current Procedural Terminology (CPT®) |
| http://www.ama-assn.org/go/cpt | Current Procedural Terminology (CPT®) |
FHIR{
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{
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"concept" : [
{
"code" : "99202",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded."
},
{
"code" : "99203",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded."
},
{
"code" : "99204",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded."
},
{
"code" : "99205",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded."
},
{
"code" : "99212",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded."
},
{
"code" : "99213",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded."
},
{
"code" : "99214",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded."
},
{
"code" : "99215",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
},
{
"code" : "99242",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded."
},
{
"code" : "99243",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded."
},
{
"code" : "99244",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
},
{
"code" : "99245",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded."
},
{
"code" : "99358",
"display" : "Prolonged evaluation and management service before and/or after direct patient care; first hour"
},
{
"code" : "99359",
"display" : "Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (List separately in addition to code for prolonged service)"
},
{
"code" : "99381",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)"
},
{
"code" : "99382",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)"
},
{
"code" : "99383",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)"
},
{
"code" : "99384",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years)"
},
{
"code" : "99385",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years"
},
{
"code" : "99386",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years"
},
{
"code" : "99387",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older"
},
{
"code" : "99391",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)"
},
{
"code" : "99392",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)"
},
{
"code" : "99393",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)"
},
{
"code" : "99394",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)"
},
{
"code" : "99395",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years"
},
{
"code" : "99396",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years"
},
{
"code" : "99397",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older"
},
{
"code" : "99401",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes"
},
{
"code" : "99402",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes"
},
{
"code" : "99403",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes"
},
{
"code" : "99404",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes"
},
{
"code" : "99406",
"display" : "Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes"
},
{
"code" : "99407",
"display" : "Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes"
},
{
"code" : "99408",
"display" : "Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes"
},
{
"code" : "99409",
"display" : "Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; greater than 30 minutes"
},
{
"code" : "99411",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes"
},
{
"code" : "99412",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes"
},
{
"code" : "99415",
"display" : "Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (List separately in addition to code for outpatient Evaluation and Management service)"
},
{
"code" : "99416",
"display" : "Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (List separately in addition to code for prolonged service)"
},
{
"code" : "99417",
"display" : "Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (List separately in addition to the code of the outpatient Evaluation and Management service)"
},
{
"code" : "99424",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month."
},
{
"code" : "99425",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"code" : "99426",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; first 30 minutes of clinical staff time directed by physician or other qualified health care professional, per calendar month."
},
{
"code" : "99427",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"code" : "99429",
"display" : "Unlisted preventive medicine service"
},
{
"code" : "99437",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; each additional 30 minutes by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"code" : "99439",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"code" : "99450",
"display" : "Basic life and/or disability examination that includes: Measurement of height, weight, and blood pressure; Completion of a medical history following a life insurance pro forma; Collection of blood sample and/or urinalysis complying with \"chain of custody\" protocols; and Completion of necessary documentation/certificates."
},
{
"code" : "99451",
"display" : "Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a written report to the patient's treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time"
},
{
"code" : "99452",
"display" : "Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes"
},
{
"code" : "99453",
"display" : "Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment"
},
{
"code" : "99454",
"display" : "Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days"
},
{
"code" : "99455",
"display" : "Work related or medical disability examination by the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report."
},
{
"code" : "99456",
"display" : "Work related or medical disability examination by other than the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report."
},
{
"code" : "99457",
"display" : "Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes"
},
{
"code" : "99458",
"display" : "Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; each additional 20 minutes (List separately in addition to code for primary procedure)"
},
{
"code" : "99459",
"display" : "Pelvic examination (List separately in addition to code for primary procedure)"
},
{
"code" : "99483",
"display" : "Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: Cognition-focused evaluation including a pertinent history and examination, Medical decision making of moderate or high complexity, Functional assessment (eg, basic and instrumental activities of daily living), including decision-making capacity, Use of standardized instruments for staging of dementia (eg, functional assessment staging test [FAST], clinical dementia rating [CDR]), Medication reconciliation and review for high-risk medications, Evaluation for neuropsychiatric and behavioral symptoms, including depression, including use of standardized screening instrument(s), Evaluation of safety (eg, home), including motor vehicle operation, Identification of caregiver(s), caregiver knowledge, caregiver needs, social supports, and the willingness of caregiver to take on caregiving tasks, Development, updating or revision, or review of an Advance Care Plan, Creation of a written care plan, including initial plans to address any neuropsychiatric symptoms, neuro-cognitive symptoms, functional limitations, and referral to community resources as needed (eg, rehabilitation services, adult day programs, support groups) shared with the patient and/or caregiver with initial education and support. Typically, 60 minutes of total time is spent on the date of the encounter."
},
{
"code" : "99484",
"display" : "Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes, facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and continuity of care with a designated member of the care team."
},
{
"code" : "99487",
"display" : "Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored, moderate or high complexity medical decision making; first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month."
},
{
"code" : "99489",
"display" : "Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored, moderate or high complexity medical decision making; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"code" : "99490",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; first 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month."
},
{
"code" : "99491",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month."
},
{
"code" : "99497",
"display" : "Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate"
},
{
"code" : "99498",
"display" : "Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure)"
},
{
"code" : "99499",
"display" : "Unlisted evaluation and management service"
}
]
}
]
},
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"identifier" : "urn:uuid:3fda5f45-ef36-4185-b21b-cc7fee8a4391",
"timestamp" : "2024-12-10T05:54:37-05:00",
"total" : 67,
"contains" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99202",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99203",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99204",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99205",
"display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99212",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99213",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99214",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99215",
"display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99242",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99243",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99244",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99245",
"display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99358",
"display" : "Prolonged evaluation and management service before and/or after direct patient care; first hour"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99359",
"display" : "Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (List separately in addition to code for prolonged service)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99381",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99382",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99383",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99384",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99385",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99386",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99387",
"display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99391",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99392",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99393",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99394",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99395",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99396",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99397",
"display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99401",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99402",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99403",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99404",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99406",
"display" : "Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99407",
"display" : "Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99408",
"display" : "Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99409",
"display" : "Alcohol and/or substance (other than tobacco) abuse structured screening (eg, AUDIT, DAST), and brief intervention (SBI) services; greater than 30 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99411",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99412",
"display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99415",
"display" : "Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (List separately in addition to code for outpatient Evaluation and Management service)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99416",
"display" : "Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (List separately in addition to code for prolonged service)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99417",
"display" : "Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (List separately in addition to the code of the outpatient Evaluation and Management service)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99424",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99425",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99426",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; first 30 minutes of clinical staff time directed by physician or other qualified health care professional, per calendar month."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99427",
"display" : "Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99429",
"display" : "Unlisted preventive medicine service"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99437",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; each additional 30 minutes by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99439",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99450",
"display" : "Basic life and/or disability examination that includes: Measurement of height, weight, and blood pressure; Completion of a medical history following a life insurance pro forma; Collection of blood sample and/or urinalysis complying with \"chain of custody\" protocols; and Completion of necessary documentation/certificates."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99451",
"display" : "Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a written report to the patient's treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99452",
"display" : "Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99453",
"display" : "Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99454",
"display" : "Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99455",
"display" : "Work related or medical disability examination by the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99456",
"display" : "Work related or medical disability examination by other than the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99457",
"display" : "Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99458",
"display" : "Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; each additional 20 minutes (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99459",
"display" : "Pelvic examination (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99483",
"display" : "Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: Cognition-focused evaluation including a pertinent history and examination, Medical decision making of moderate or high complexity, Functional assessment (eg, basic and instrumental activities of daily living), including decision-making capacity, Use of standardized instruments for staging of dementia (eg, functional assessment staging test [FAST], clinical dementia rating [CDR]), Medication reconciliation and review for high-risk medications, Evaluation for neuropsychiatric and behavioral symptoms, including depression, including use of standardized screening instrument(s), Evaluation of safety (eg, home), including motor vehicle operation, Identification of caregiver(s), caregiver knowledge, caregiver needs, social supports, and the willingness of caregiver to take on caregiving tasks, Development, updating or revision, or review of an Advance Care Plan, Creation of a written care plan, including initial plans to address any neuropsychiatric symptoms, neuro-cognitive symptoms, functional limitations, and referral to community resources as needed (eg, rehabilitation services, adult day programs, support groups) shared with the patient and/or caregiver with initial education and support. Typically, 60 minutes of total time is spent on the date of the encounter."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99484",
"display" : "Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of applicable validated rating scales, behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes, facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation, and continuity of care with a designated member of the care team."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99487",
"display" : "Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored, moderate or high complexity medical decision making; first 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99489",
"display" : "Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored, moderate or high complexity medical decision making; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99490",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; first 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99491",
"display" : "Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month."
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99497",
"display" : "Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99498",
"display" : "Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (List separately in addition to code for primary procedure)"
},
{
"system" : "http://www.ama-assn.org/go/cpt",
"version" : "2025",
"code" : "99499",
"display" : "Unlisted evaluation and management service"
}
]
},
"text" : {
}
}
XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.