How many minutes is 99205?
Asked by: Audra Crooks | Last update: July 30, 2025Score: 4.1/5 (56 votes)
What does CPT code 99205 mean?
99205 Description: 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 medical decision making.
How many minutes for a 99214?
CPT® code 99214: Established patient office visit, 30-39 minutes | American Medical Association.
What is the CPT code for a 2 hour session?
This is a super short guide on billing a typical 2 hour individual therapy session for outpatient mental health therapy. You'll want to use your typical 90837 CPT code.
What is the time limit for CPT code 99205?
CPT code 99205 is used for new patient office or outpatient visits that require comprehensive evaluation, high complexity in medical decision-making, or 60-74 minutes of patient encounter time.
What is a level 5 office / outpatient visit in medical coding? 99215 & 99205 explained.
Can you bill 99205 and 99417 together?
Both CPT ® code 99417 and HCPCS code G2212 may only be reported in conjunction with 99205 or 99215 if the codes were selected based on the time alone and not medical decision making. A service of less than 15 minutes should not be reported.
What is the difference between 99204 and 99214?
For a 99204, all three major criteria (history, physical exam and medical decision making) must be met. A 99214 requires only two of the three major criteria. For a 99204, the review of systems must include at least 10 systems or body areas. A 99214 requires a review of only two.
What is the 7 day rule for telehealth?
The communication cannot be related to a medical visit within the previous seven days and cannot lead to medical visit within the next 24 hours (or soonest appointment available). Physician or other clinician may respond to patient by telephone, audio/video, secure text messaging, email, or patient portal.
Can we code TCM and 99214 together?
Not if the 99214 visit is the one visit included in TCM. CPT states, " The first face-to-face visit is part of the TCM service and not reported separately. Additional E/M services provided on subsequent dates after the first face-to-face visit may be reported separately. "
What pays more, 99205 or 90792?
CPT® 2024 American Medical Association.
A level-four or a level-five new patient encounter will pay out higher than 90792. A level-four new patient non-facility code (99204) will pay out approximately $166.22 while a claim for 99205 will fetch $207.06.
What is the difference between 99205 and 99215?
Another important difference between the codes is that the new patient codes (99201–99205) require that all three key components (history, exam and medical decision making) be satisfied, while the established patient codes (99211–99215) require that only two of the three key components be satisfied.
Can 99205 be used for telehealth?
Office visit evaluation and management services (CPT codes 99202-99205, 99211-99215) furnished using audio-video telecommunications technology are reported using the same CPT codes as you would have had the visit been conducted in-person.
How do I bill 99205?
Time-Based Coding
Under the new guidelines, physicians now have the option to select the appropriate code based on the time spent on the patient encounter. For CPT code 99205, the typical session length is 60-74 minutes. This includes both face-to-face and non-face-to-face time spent on the patient's care.
Can you bill 99205 and 90833 together?
It is acceptable to bill CPT codes 99201-99215 and 90833 or 90836 or 90838. Behavioral health assessment/evaluation and psychotherapy Do not bill CPT codes 90791-90792 and 90832- 90838. These codes are not billable on the same date to the same member by the same provider.
Can you bill 99417 with 99205?
Add-on code +99417 relies on either 99215 or 99205 as the primary code. It becomes billable exactly one minute after the time threshold for 99215 or 99205 is exceeded. Thus to take 99205 as an example, one unit of +99417 is billable at 75 minutes. The 99205 accounts for the first 74 minutes.
What is the difference between 99205 and 99204?
Code 99204 requires a minimum of 45 minutes of face-to-face time with the patient and Code 99205 requires a minimum of 60 minutes face-to-face time with the patient. For both services, at least 50% of the face-to-face time must be spent providing counseling and/or coordination of care.
Does cpt code 99205 need a modifier?
In addition, the appropriate level of E/M service for an office or other outpatient visit for a new or established patient (99202–99205, 99212–99215) would be reported with modifier 25 appended to indicate that a significant, separately identifiable E/M service was provided.
Can I bill 90837 for 50 minutes?
Time Requirements and Service Criteria for Billing 90837
Code 90837 is for 60-minute therapy sessions, defined as 53 minutes or longer. Anything less than 53 minutes would use code 90834 (45-minute session). For 90837, the actual session time must be documented in your notes. Rounding up or down is not allowed.
Why is therapy 53 minutes?
Insurance companies encourage it
Insurance rarely pays for extended session time. So a therapist will be paid the same for a 53-minute session as a session that's longer than 60 minutes. Sticking to a 45- to 50-minute session is therefore often simpler for billing purposes.
What is the CPT code for 90 minutes?
Units vs Extended Session CPT Codes
To bill an insurance claim for a 90 minute individual therapy session: bill 90837. with add-on code 99354.