CPT® codes for patients at home in a residence: New patient: 99341, 99342, 99344, 99345 Established patient: 99347−99350 These codes are used to report services in a patient’s home or in a residence. “Home may be defined as a private residence, temporary lodging, or short -term accommodation (eg, hotel, campground, hostel, or cruise ship).” These […]
Consultation Codes
CMS stopped recognizing consult codes in 2010. Outpatient consultations (99242—99245) and inpatient consultations (99252—99255) are still active CPT® codes, and depending on where you are in the country, are recognized by a payer two, or many payers. In 2023, codes 99241 and 99251 were deleted. These two low level consult codes were rarely used. There […]
Codes for Visits in Assisted Living (and a Visit Complexity Update for 2026!)
Question: In 2026, how will we indicate practitioners are providing longitudinal or complex care who are in assisted living or receiving services in their home? Answer: In 2023, the codes for services performed in a patient’s home or in an assisted living facility were combined to one code set. Codes (99341—99345 for new patients) and (99347—99350 […]
Category of Code
Learn more about selecting Category of Code in Everyday Coding, updated annually. This article provides definitions and tips for determining whether an office encounter involves a new patient, an established patient, or a consult, and the guidelines for reporting inpatient, observation, and emergency services. The quick reference chart and key points will help you to quickly […]
New Versus Established Patient Visits
There are other articles on CodingIntel about the difference between new and established patients, and the rules haven’t changed, but that doesn’t mean it is always clear. This article is here to try and clarify any remaining questions you have about the differences. Medicare definition “Interpret the phrase “new patient” to mean a patient who […]