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Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Psych ,Physician Supplemental Evaluation | | Psychiatric diagnostic evaluation |
Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation | | Psychiatric diagnostic evaluation with medical services |
| | Psychotherapy, 30 minutes with client or family member
Do not bill with 90847 for the same DOS |
| | Psychotherapy, 45 minutes with client or family member
Do not bill with 90847 for the same DOS |
| | Psychotherapy, 60 minutes with client or family member
Do not bill with 90847 for the same DOS |
| | Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (List separately in addition to the code for primary procedure). See 90837, as this should be used with 99202-92255, 99304-99316, and 99341-99350. If billing 60M psychotherapy only, then bill 90837 |
| | Family psychotherapy (without the patient present), 50 minutes |
| | Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes
Do not report 90832-90838 with 90847 for the same DOS |
Family Caregiver Support Group, Parent/Child Group, Sibling Support Group | | Multiple-family group psychotherapy |
Family Caregiver Support Group, Parent/Child Group, Sibling Support Group | | Group psychotherapy (other than of a multiple-family group)
Do not report with 97151-97158 for the same DOS |
| | treatment of speech, language, voice, communication, and/or auditory processing disorder; individual
Do not report with 97153 and 97155 for the same DOS |
Group Developmental, Group Developmental with 1:1 Aide, Parent/Child Group | | treatment of speech, language, voice, communication, and/or auditory processing disorder; group, two (2) or more individuals
Do not report with 97154 and 97158 for the same DOS |
Physician Supplemental Evaluation | | Laryngeal function studies (i.e., aerodynamic testing and acoustic testing) This is bilateral code; if only one (1) side is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation, Non-physician Supplemental Eval - Speech | | Evaluation of speech fluency (e.g., stuttering, cluttering)
Special otorhinolaryngologic services are those diagnostic and treatment services not included in an evaluation and management service, including office or other outpatient services (99202-99215) |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation, Non-physician Supplemental Eval - Speech | | Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)
Special otorhinolaryngologic services are those diagnostic and treatment services not included in an evaluation and management service, including office or other outpatient services (99202-99215) |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation, Non-physician Supplemental Eval - Speech | | Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria); with an evaluation of language comprehension and expression (e.g., receptive and expressive language)
Special otorhinolaryngologic services are those diagnostic and treatment services not included in an evaluation and management service, including office or other outpatient services (99202-99215) |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation, Non-physician Supplemental Eval - Speech | | Behavioral and qualitative analysis of voice and resonance
Special otorhinolaryngologic services are those diagnostic and treatment services not included in an evaluation and management service, including office or other outpatient services (99202-99215) |
| | treatment of swallowing dysfunction and/or oral function for feeding
Special otorhinolaryngologic services are those diagnostic and treatment services not included in an evaluation and management service, including office or other outpatient services (99202-99215) |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Tympanometry and reflex threshold measurements
Do not use it in conjunction with 92567. All services include testing of both ears; if only 1 ear, use modifier 52 |
| | Screening test, pure tone, air only
This is bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Pure tone audiometry (threshold); air only
This is bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment | | Pure tone audiometry (threshold); air and bone
This is bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Speech audiometry threshold
This is bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Speech audiometry threshold with speech recognition
This is a bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined) |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Tympanometry (impedance testing)
This is a bilateral code; if only 1 ear is tested, use modifier 52 |
Non-physician Supplemental Eval - Audiology | | Acoustic reflex testing, threshold
For eval of speech, language, and/or hearing problems through observation and assessment of performance, see 92521, 92522, 92523, 92524. If the test is performed on only 1 ear, it has to be billed with modifier 52. |
Non-physician Supplemental Eval - Audiology | | Acoustic immittance testing includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing.
Do not report w 92568. also; if it is one ear, not two, they must use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Filtered speech test
This is a bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Visual reinforcement audiometry (VRA)
This is a bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Conditioning play audiometry
This is a bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Select picture audiometry
This is a bilateral code; if only 1 ear is tested, use modifier 52 |
Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
Non-physician Supplemental Eval - Audiology, Psychology | | Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
Non-physician Supplemental Eval - Audiology, Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Hearing aid examination and selection; monaural |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Hearing aid examination and selection; binaural; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Hearing aid check; monaural |
Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Hearing aid check; binaural; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Electroacoustic evaluation for a hearing aid; binaural; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
Non-physician Supplemental Eval - Audiology, Physician Supplemental Evaluation | | Ear protector attenuation measurements: this is a bilateral code; if only 1 ear is tested, use modifier 52 |
Applied Behavior Analyst Services, Physician Supplemental Evaluation, Non-physician Supplemental Eval - Speech | | Evaluation of oral and pharyngeal swallowing function |
Audiology, Speech Language | | Auditory rehabilitation; pre-lingual hearing loss |
Audiology, Speech Language | | Auditory rehabilitation; post-lingual hearing loss |
Physician Supplemental Evaluation, Audiology | | Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis (effective 1/1/21); this is a bilateral code; if only 1 ear is tested, use modifier 52 |
| | Auditory evoked potentials for hearing status determination, broadband stimuli, with interpretation and report (effective 1/1/21)
Do not bill with 92652 and 92653; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
| | Auditory evoked potentials for threshold estimation at multiple frequencies, with interpretation and report (effective 1/1/21)
Do not bill with 92651 and 92653; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
| | Auditory evoked potentials; neurodiagnostic, with interpretation and report (effective 1/1/21)
Do not bill with 92651 and 92652; this is a bilateral code; if only 1 ear is tested, use modifier 52 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation, Non-physician Supplemental Eval - Speech | | Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, e.g., by Boston Diagnostic Aphasia Examination) with interpretation and report, per hour
For the development of cognitive skills, see 97533 |
| | Developmental testing; limited (e.g., Developmental Screening Test II, Early Language Milestone Screen), with interpretation and report
To report developmental testing, see 96112 and 96113 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation, Screening Evaluation, Non-physician Supplemental Eval - Speech | | Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour
For the development of cognitive skills, see 97533 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation, Screening Evaluation, Non-physician Supplemental Eval - Speech | | Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed) by a physician or other qualified health care professional, with interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure)
For the development of cognitive skills, see 97533 |
Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation | | Neurobehavioral status exam (clinical assessment of thinking, reasoning, and judgment, [e.g., acquired knowledge, attention, language, memory, planning and problem-solving, and visual-spatial abilities]) by a physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour |
Non-physician Supplemental Eval – Psych ,Parent/Child Group | | Neurobehavioral status exam (clinical assessment of thinking, reasoning, and judgment, [e.g., acquired knowledge, attention, language, memory, planning and problem-solving, and visual-spatial abilities]), by a physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; each additional hour (List separately in addition to code for primary procedure) |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Psych,Physician Supplemental Evaluation | | Psychological testing evaluation services by a physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour
For the development of cognitive skills, see 97533 |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation | | Psychological testing evaluation services by a physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; each additional hour (List separately in addition to code for primary procedure)
For development of cognitive skills see 97533 |
Non-physician Supplemental Eval - Psych, Non-physician Supplemental Eval - Social Work, Physician Supplemental Evaluation | | Health behavior assessment, or re-assessment (i.e., Health-focused clinical interview, behavioral observations, clinical decision making) |
| | Health behavior intervention, individual, face-to-face; initial 30 minutes |
| | ADD ON Health behavior intervention, individual, face-to-face; each additional 15 minutes (List separately in addition to code for primary service) |
Group Developmental with 1:1 Aide | | Health behavior intervention, group (2 or more
patients), face-to-face; initial 30 minutes |
Group Developmental with 1:1 Aide | | ADD ON Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (List separately in addition to code for primary service) |
| | The therapeutic procedure 1 or more areas every 15 minutes; therapeutic exercises to develop strength and endurance, range of motion, and flexibility
For group therapeutic procedure, see 97150 |
| | Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities
For group therapeutic procedure, see 97150 |
| | Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing) |
| | Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)
For myofascial release, see 97140 |
| | Manual therapy techniques (e.g., mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes |
Group Developmental, Group Developmental with 1:1 Aide | | Therapeutic procedure(s), group (2 or more individuals)
CPT 97150 should be reported for each member of the group (2 or more individuals) |
Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation | | Behavior identification assessment, administered by a physician or other qualified health care professional, every 15 minutes of the physician’s or other qualified health care professional’s time face-to-face with patient and/or guardian(s)/caregiver(s) administering assessments and discussing findings and recommendations, and non-face-to-face analyzing past data, scoring/interpreting the assessment, and preparing the report/treatment plan |
Non-physician Supplemental Eval - Psych, Physician Supplemental Evaluation | | Behavior identification supporting assessment, administered by one technician under the direction of a physician or other qualified health care professional, face-to-face with the patient, each 15 minutes
CPT 97151 and 97152 may be repeated on the same or different days until the behavior identification assessment [97151] and, if necessary, supporting assessment [97152] is complete. For psychiatric diagnostic evaluation, see 90791 and 90792. |
Applied Behavior Analyst Services | | Adaptive behavior treatment by protocol, administered by a technician under the direction of a physician or other qualified health care professional, face-to-face with one patient; each 15 minutes
Adaptive behavior treatment codes 97154, 97155, and 97158 describe services that address specific treatment targets and goals based on results of previous assessments [see 97151, 97152] and include ongoing assessment and adjustment of treatment protocols, targets, and goals. |
Group Developmental, Group Developmental with 1:1 Aide | | Group adaptive behavior treatment by protocol, administered by a technician under the direction of a physician or other qualified health care professional, face-to-face with two or more patients, each 15 minutes
Do not report 97154 for a group with >8 patients. Do not report 97154 with 90785-90899, 92508, 96105-96171, or 97150. |
Applied Behavior Analyst Services | | Adaptive behavior treatment with protocol modification administered by a physician or other qualified health care professional, which may include simultaneous direction of technician, face-to-face with one patient, each 15 minutes
Do not report with 90785-90899, 92507, 96105-96171, or 97150. |
Group Developmental, Group Developmental with 1:1 Aide | | Group adaptive behavior treatment with protocol modification, administered by a physician or other qualified health care professional face-to-face with multiple patients, each 15 minutes
Do not report for a group with more than 8 patients. Do not report with 90785-90899, 96105-96171, 92508, or 97150. |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - PT, Physician Supplemental Evaluation | | Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family. |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - PT, Physician Supplemental Evaluation | | Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family. |
Multi-disciplinary Evaluation & Assessment, Non-physician Supplemental Eval - PT, Physician Supplemental Evaluation | | Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation, Non-physician Supplemental Eval - OT | | Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; An assessment(s) that identifies 1-3 performance deficits (i.e., relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of low complexity, which includes an analysis of the occupational profile, analysis of data from problem-focused assessment(s), and consideration of a limited number of treatment options. The patient presents with no comorbidities that affect occupational performance. Modification of tasks or assistance (e.g., physical or verbal) with assessment(s) is not necessary to enable completion of the evaluation component. Typically, 30 minutes are spent face-to-face with the patient and/or family. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation, Non-physician Supplemental Eval - OT | | Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 3-5 performance deficits (i.e., relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of moderate analytic complexity, which includes an analysis of the occupational profile, analysis of data from detailed assessment(s), and consideration of several treatment options. The patient may present with comorbidities that affect occupational performance. Minimal to moderate modification of tasks or assistance (e.g., physical or verbal) with assessment(s) is necessary to enable the patient to complete the evaluation component. Typically, 45 minutes are spent face-to-face with the patient and/or family. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation, Non-physician Supplemental Eval - OT | | Occupational therapy evaluation, high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 5 or more performance deficits (i.e., relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of high analytic complexity, which includes an analysis of the patient profile, analysis of data from comprehensive assessment(s), and consideration of multiple treatment options. The patient presents with comorbidities that affect occupational performance. Significant modification of tasks or assistance (e.g., physical or verbal) with assessment(s) is necessary to enable the patient to complete the evaluation component. Typically, 60 minutes are spent face-to-face with the patient and/or family. |
| | Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes |
| | Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes |
Assistive Technology, OT, PT | | Self-care/home management training (e.g., activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in the use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 15-minute |
Assistive Technology, OT, PT | | Wheelchair management (e.g., assessment, fitting, training), each 15-minute |
Non-physician Supplemental Eval - Assistive Tech, Physician Supplemental Evaluation | | Assistive technology assessment (e.g., to restore, augment, or compensate for existing function, optimize functional tasks, and/or maximize environmental accessibility), direct one-on-one contact, with a written report, every 15 minutes. |
| | Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes
Should not be reported with 97116 for same extremity(ies). Codes 97010-97763 should be used to report each distinct procedure performed. Do not append modifier 51 to 97010-97763. |
| | Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes |
| | Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes
Do not report 97763 with 97760, 97761 |
Non-physician Supplemental Eval - Nutrition, Physician Supplemental Evaluation, Nutrition | | Medical nutrition therapy: initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes |
Non-physician Supplemental Eval - Nutrition, Physician Supplemental Evaluation, Nutrition | | Medical nutrition therapy: re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | An office or other outpatient visit is required for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and a a low level of medical decision-making. When using time for code selection, 30-44 minutes of total time is spent on the date of the encounter. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 45-59 minutes of total time is spent on the date of the encounter. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and a high level of medical decision making. When using time for code selection, 60-74 minutes of total time is spent on the date of the encounter.
CPT 99417 is for service 75 minutes or longer; this is not currently an EI code, did you want to have it considered? |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 10-19 minutes of total time is spent on the date of the encounter. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision-making. When using time for code selection,30-39 minutes of total time is spent on the date of the encounter. |
Multi-disciplinary Evaluation & Assessment, Physician Supplemental Evaluation | | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a high level of medical decision-making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter. |
Family Counseling, Family Caregiver Support Group, Family Support, Parent/Child Group, Psychology, Social Work, Sibling Support Group | | Home visit for individual, family, or marriage counseling |
| | Non-emergency transportation, per mile - vehicle provided by an individual (family member, self, neighbor) with a vested interest |
| | Non-emergency transportation and bus, intra or inter state carrier |
| | Durable medical equipment, miscellaneous |
| | Therapeutic behavioral services per 15 minutes |
Non-physician Supplemental Eval - Special Inst, Special Instruction | | Psychoeducational service, per 15 minutes |
| | Repair of a prosthetic device, repair or replace minor parts. |
| | Unskilled respite care, not hospice, per 15 minutes |
Family Caregiver Support Group, Parent/Child Group, Sibling Support Group | | Patient education, not otherwise classified, non-physician provider, group, per session |
Non-physician Supplemental Eval - Nursing | | Nursing assessment/evaluation |
| | Rn services, up to 15 minutes |
| | Lpn/lvn services, up to 15 minutes |
Bilingual Multi-disciplinary Evaluation Add On, Bilingual Evaluation Add on – Non Physician, Bilingual Evaluation Add on - Physician, Speech Language | | Sign language or oral interpretive services, per 15 minutes |
Service Coordination - Initial, Service Coordination - Ongoing | | Targeted case management, each 15 min (TL Modifier) |
| | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project, or treatment protocol per encounter |
Family Counseling, Family Caregiver Support Group, Family Support, Family Training, Parent/Child Group, Sibling Support Group | | Family training and counseling for child development, per 15 minutes (effective 1/1/2013) |
| | Non-emergency transportation (each one-way trip) |
Non-physician Supplemental Eval - Vision, Vision, ATD DME | | Vision item or service, miscellaneous |
| | Assessment for hearing aid |
| | Fitting/orientation/checking of hearing aid |
| | Repair/modification of a hearing aid |
Non-physician Supplemental Eval - Audiology | | |
| | Earmold/insert, not disposable, any type |
| | Hearing aid or assistive listening device/supplies/accessories not otherwise specified. |
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