99220 CPT Code Description

99220 CPT Code Description

The attending physician skillfully applies CPT code 99220 to meticulously document hospital observation care services provided to new and established patients. Observation care is a specialized service that involves a brief inpatient stay where the patient’s condition is closely monitored and thoroughly assessed to determine the necessity of hospitalization or the ability to return home safely. 

Related Code: 99214 CPT code description

Providing the best possible care to patients and keeping their health as the top priority requires a careful and detailed assessment. It may include:

  • Conducting a thorough medical history and physical examination.
  • Ordering and interpreting diagnostic tests and procedures.
  • Developing and managing a treatment plan.
  • Providing patient education and counseling.

Service level for CPT 99220 is time-based and determined by the physician’s care time. Three service levels exist, shown in the table below:

Level of service Time spent
99220 30 minutes or more
99221 20-29 minutes
99222 10-19 minutes

Can you bill 99220 and 99217 together?

No. Because observation care codes 99218–99220 and discharge code 99217 cannot be used on the same day. Use them on separate dates of service.

CPT code 99220 reimbursement

Medicare Part B covers your doctor’s services for hospital observation services without admission, but you’ll pay 20% coinsurance after the deductible.

Is CPT 99220 valid for 2023?

Starting Jan 1, 2023, CPT code 99220 is invalid. Observation care codes 99217–99220 and 99224–99226 will merge into hospital inpatient codes. A new subsection will cover this. Practitioners can still bill for observation services using revised codes.

Does Medicare cover CPT code 99220?

Medicare covers CPT code 99220, but copays/deductibles may apply. Check with your carrier.

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