What is the CPT code for primary care visit?
Asked by: Danielle Schuppe V | Last update: January 26, 2026Score: 4.8/5 (8 votes)
What is the difference between CPT 99213 and 99214?
An expanded problem-focused history, consistent with a 99213, requires one to three HPI elements while a detailed history consistent with a 99214 requires four or more HPI elements.
What is the difference between 99222 and 99223?
99222 Initial hospital inpatient or observation care, per day, moderate medical decision making. 99223 Initial hospital inpatient or observation care, per day, high-level medical decision making.
How do you determine which CPT code is primary?
Often, a parenthetical note will identify the primary code(s) with which the add-on code must be reported. For example, following 10004 in the CPT® codebook is a parenthetical instruction “Use 10004 in conjunction with 10021.” On other occasions, however, the codebook doesn't provide the primary procedure code(s).
What is the primary care code?
Primary care CPT codes 99211-99215 and 99202-99205 are used to bill for evaluation and management services provided in an office or other outpatient setting. These codes vary based on the visit's complexity, with lower-level codes for less complex visits and higher-level codes for more complex visits.
Medical Coding Case Study - Evaluation and Management Walkthrough and Explanations for Beginners
What is the CPT code for primary care visits?
- CPT Code 99202-99205 – Outpatient E/M Visit, New Patient. ...
- CPT Code 99211-99215 – Outpatient E/M Visit, Established Patient. ...
- CPT Codes 91318-91322 – COVID-19 Vaccine & Immunization. ...
- CPT Codes 90736 and 90750 – Shingles Vaccine.
How do I find my primary care physician code?
In most cases, the Provider ID can be found by searching for the provider on an insurance carrier's Find A Provider tool on their website. If the carrier does not show the Provider ID number in their directory, the provider themselves can give their ID number.
What is the CPT code for office visits?
Office or Other Outpatient Services CPT® Code range 99202- 99215. The Current Procedural Terminology (CPT) code range for Office or Other Outpatient Services 99202-99215 is a medical code set maintained by the American Medical Association.
What are the primary codes for CPT 15777?
Generally accepted primary (and associated add-on) procedures for +15777 include autografts/allografts and skin substitute procedures of the trunk (15040-15278), as well as breast repair and reconstructions (19316-19396).
What is the primary code for CPT 90833?
CPT Codes 90832-90838 represent psychotherapy. Psychotherapy without medical evaluation and management services are reported as 90832, 90834 and 90837. Psychotherapy with medical evaluation and management services are reported with codes for E/M services plus a psychotherapy add-on code (90833; 90836; 90838).
What does CPT code 99222 mean?
99222: Initial hospital inpatient or observation care, per day for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of MDM.
How many times can you bill 99223 per day?
You can report a code from the 99221-99223 range (Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components …) range only once per day.
What is the CPT code for consultation visits?
Office or Other Outpatient Consultations CPT® Code range 99242- 99245. The Current Procedural Terminology (CPT) code range for Office or Other Outpatient Consultations 99242-99245 is a medical code set maintained by the American Medical Association.
What is a 99214 in primary care?
CPT defines a 99214 or level-IV established patient visit as one involving a detailed history, detailed examination and medical decision making of moderate complexity.
What is the CPT code for home visit established patient?
99349: Home visit for the evaluation and management of an established patient requiring a detailed history, detailed examination, and moderate-complexity medical decision-making, typically 40 minutes spent face-to-face with the patient. For patients with more complex conditions needing ongoing management at home.
What is CPT code 99223?
According to CPT, the initial hospital care codes, 99221–99223, are for “the first hospital inpatient encounter with the patient by the admitting physician.” Initial inpatient encounters by other physicians should be reported with either subsequent hospital care codes (99231–99233) or initial inpatient consultation ...
What is the CPT code for primary care?
The primary care CPT codes 99211-99215 and 99202-99205 are used to bill for evaluation and management services provided in an office or other outpatient setting.
What is the primary code for 22853?
CPT code 22853 is used to describe the insertion of a biomechanical device, such as an intervertebral body fusion device, during spinal surgery. This code is specifically utilized when a surgeon places a device between the vertebrae to help stabilize the spine and promote bone fusion.
What is the CPT code 19325?
CPT code 19325 is used to describe the surgical procedure for breast augmentation with implants. This code is specifically assigned to the operation where a surgeon places breast implants to enhance the size and shape of a patient's breasts.
What is the E&M code for office visit?
To report an office or other outpatient visit for a new patient, you'll choose from E/M codes 99201-99205. As this article mentioned previously, office/outpatient visits include history, clinical examination, and medical decision-making (MDM) as the three key components for code selection.
What is the CPT code for preventive office visit?
Preventive visit codes 99381-99397 include “counseling/anticipatory guidance/risk factor reduction interventions,” according to CPT. However, when such counseling is provided as part of a separate problem-oriented encounter, it may be billed using preventive medicine codes 99401-99409.
What is CPT code 99213 used for?
CPT® code 99213: Established patient office or other outpatient visit, 20-29 minutes. As the authority on the CPT® code set, the AMA is providing the top-searched codes to help remove obstacles and burdens that interfere with patient care.
What is the primary care physician also called?
Your PCP will be your partner, sharing the responsibility for your physical and mental health and well-being. Primary care physicians are also called general practitioners because they cover all types of everyday health concerns. Your PCP can answer questions about infections, chronic conditions or medicines.
What is the code for physician office?
Office visit services (CPT codes 99202-99205, 99211-99215)
How to get a primary care doctor with insurance?
Find a PCP by calling your insurance company, asking friends or family, or visiting a website that locates healthcare providers. Many insurance company websites will have a search box to find someone in your network.