CPT code 99215 is typically utilized when reporting evaluation and management services rendered to an established patient in an office or outpatient setting. This visit involves a high level of medical decision-making. Therefore, the 99215 code represents the highest level of care that can be provided to established patients who are being seen in the office.
Also read: CPT code 99214 description.
What are the criteria for billing a 99215?
In order to charge for a CPT code of 99215, provider is required to dedicate between 40-54 minutes to an office or outpatient visit for an established patient. This visit should consist of a medically necessary history and/or examination and involve a high level of medical decision-making. While standard time allotment for 99215 is 40 minutes, however, certain tasks may necessitate additional time to be properly addressed.
What is the difference between 99214 and 99215?
Both codes have a few differences,
- 99214: moderate MDM and 30-39 mins.
- 99215: high MDM and 40-54 mins.
Can you bill 99215 with a home visit?
No, you can’t use it. For a home visit, there are different CPT codes.
Also read: CPT code 11750 description
Does Medicare cover CPT code 99215?
Medicare reimburses $200.00 for procedure code 99215. A separate rate is paid for level-5 visits (99205, 99215). An add-on code can be added to office/outpatient visits for new or established patients, permanently listed in Medicare telehealth.
Can a nurse practitioner bill a 99215?
Yes, they can bill CPT codes following the same guidelines as other providers.