AMA CPT® Assistant - 1994 Issue 2 (Summer)
Care Plan Oversight Services (Summer 1994)
Summer 1994 page 9 Care Plan Oversight Services A new category of codes (99375, 99376) was added to CPT 1994 for Care Plan Oversight. These codes describe the services a physician provides when he/she oversees the care of the patient, yet does not see the patient (face-to-face) during an extended period of time (eg, 30 day period). Although the physician does not see the patient, he/she is directing and coordinating the care the patient receives from other health care professionals/agencies. 99375Physician supervision of patients under care of home health agencies, hospice or nursing facility patients (patient not present) requiring...
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Article Overview
This premium article reviews a CPT update focused on care plan oversight services and the general framework for reporting them in 1994. It is aimed at physicians, coders, and billing staff who need to understand the scope of the new category, the kinds of care settings involved, and the broad documentation and time-based considerations discussed by CPT Assistant. The article also includes narrative examples and discussion of how the service fits within broader E/M-related work.
Why This Topic Matters
Understanding this article helps readers recognize the general intent and placement of the 1994 CPT care plan oversight category in relation to patient management outside direct face-to-face encounters.
Article Sections
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Summer 1994 page 9
Introductory material identifying the issue and page location for the CPT Assistant discussion.
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Care Plan Oversight Services
Overview of the new CPT care plan oversight category and the general setting in which the services are described.
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Example #1
A narrative example illustrating the kind of care coordination scenario discussed in the article.
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Discussion:
General discussion of reporting considerations, patient setting, time period, and the broader relationship to E/M services.
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Example #2
A second narrative example showing another care coordination scenario addressed by the article.
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Discussion:
Follow-up discussion of the general circumstances under which the service is and is not addressed in the article.
What You Will Learn
- The purpose and scope of the CPT care plan oversight category
- The types of care settings associated with the discussion
- How the article frames time-based service considerations
- How the article relates care plan oversight to broader E/M work
- The role of narrative examples in illustrating the topic
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
Codes Discussed
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