An Ultimate Guide to Master 99205 CPT Code in 2024


When it comes to mastering CPT Codes, 99205 CPT Code is one of the most important medical billing codes. So, it’s one of the most important codes that every healthcare organization or clinic must know to use accurately during the medical billing and reimbursement processes.

This article will explain everything about the 99205 CPT, its importance, billing guidelines, requirements, criteria, and mistakes to avoid. By the end of this article, you’ll be a master of 99205 CPT Code. So, without any further delay, let’s begin!

What is CPT Code 99205?

99205 CPT Code is a high-level evaluation and management code used for new patient visits, both office and outpatient visits. This code is especially used for new patients who require 60-74 minutes face-to-face on the visit date because they have complex medical issues and require a comprehensive evaluation with high-level decision-making.

What Level of Care is 99205?

It requires Level-5 care, which represents the highest level of care for new patients in outpatients/office visits. This means that doctors need to perform a very detailed patient evaluation with a high level of decision-making. It suppresses the requirements of lower CPT codes like 99204.

CPT Code 99205 Billing Guidelines

When billing the CPT Code 99205 then there are some key rules to follow:

1. High Level of Decision-Making

This code is used when doctors need to handle complex medical issues of patients, which may involve multiple tests, reviewing medical records, and creating personalized diagnoses and treatment plans by spending most of their time with patients.

2. Comprehensive History or Exam

The doctor needs to conduct a detailed review of the patient’s medical history, identify symptoms, and get past treatment records to understand the patient’s current condition fully.

3. Session Length

A typical visit of new patients for complex medical issues lasts between 60-74 minutes, including face-to-face time and 99205 times spent reviewing their cases.

In short, CPT 99205 is used for new patients who have complex issues that require 60-74 minute visits for proper documentation, decision-making, and treatment plans. 

Conclusion

Overall, the CPT Code 99205 is one of the essential codes for medical billing, which comes under high-level medical services and allows for high reimbursement for healthcare organizations and clinics. So, healthcare providers need to understand everything about the 99205 Code to use while billing and get accurate reimbursement for their medical services. We hope this guide helps you know everything about the 99205 CPT Code, its level, importance, guidelines, requirements, and common mistakes to avoid getting the proper reimbursement.

To know more about the 99205 CPT Code, you can get in touch with our experts at VCDoctor, a telemedicine app development company

Original Blog Source: https://www.vcdoctor.com/blog/99205-cpt-code

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