Billing and Coding

Billing for time

99381New, < 12 months
99382New, 1-4
99383New, 5-11
99384New, 12-17
99385New, 18-39
99386New, 39-64
99387New, 65+
99391Established, < 12 months
99392Established, 1-4
99393Established, 5-11
99394Established, 12-17
99395Established, 18-39
99396Established, 39-64
99397Established, 65+
99341New, home visit, straightforward MDM or at least 15 minutes total time
99342New, home visit, low level MDM or at least 30 minutes total time
99344New, home visit, moderate level MDM or at least 60 minutes total time
99345New, home visit, high level MDM or at least 75 minutes total time
99347Established, home visit, straightforward MDM or at least 20 minutes total time
99348Established, home visit, low level MDM or at least 30 minutes total time
99349Established, home visit, moderate level MDM or at least 40 minutes total time
99350Established, home visit, high level MDM or at least 60 minutes total time
G0438Medicare Annual Wellness Visit within first 12 months
G0439Medicare Annual Wellness Visit after first 12 months
99495TCM, Moderate complexity, within 14 days
99496TCM, High complexity, within 7 days
99455FMCSA (DOT) Physical
99406Smoking and tobacco use cessation counseling visit, greater than 3 minutes up to 10 minutes + 25 modifier
99407Smoking and tobacco use cessation counseling visit, greater than 10 minutes + 25 modifier
G0444Mental Health Screening (PHQ-9) + 25 modifier
G2211Add-on code for multiple chronic conditions that require more detailed management or evaluation and/or medical decision-making that is more complex + 25 modifier
G2010Remote Evaluation of Video/Images, Asynchronous
G2012Remote Evaluation (5-10 minutes), Synchronous (real-time communication, usually by phone or video)
99497Advance Care Planning Discussion + 25 modifier
99401Preventive medicine counseling (15 minutes), For counseling about healthy lifestyle changes (diet, exercise, etc.) + 25 modifier
99402Preventive medicine counseling (30 minutes) + 25 modifier
99403Preventive medicine counseling (45 minutes) + 25 modifier
99354Prolonged service, first 30 minutes + 25 modifier
99355Prolonged service, each additional 30 minutes + 25 modifier
99490Chronic care management (at least 20 minutes of non-face-to-face time), For managing chronic diseases such as diabetes, hypertension, etc.
99439Remote patient monitoring (more than 20 minutes), For remote monitoring of patient data (e.g., blood pressure, glucose levels) + 25 modifier
J3490PROProparacaine Eye Drops + 25 modifier
95251CGM data > 72 hours + 25 modifier