Evaluation and Management (November 2004)

November 2004 page 11a Coding Consultation:Questions and Answers Evaluation and Management, 99201-99215 (Q&A) Question Can evaluation and management codes 99201-99215 (excluding 99211) be used by midlevel providers, or are these codes limited to usage by physicians (face-to-face time)? AMA Comment From a CPT coding perspective, codes 99201-99215 (excluding 99211) are intended to be reported for physician office or other outpatient visits. However, many thirdparty payers have allowed these codes to be reported by nonphysician health care professionals. It is recommended that you check with the third-party payers policies prior to reporting the codes by nonphysician health care professionals...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This short AMA CPT Assistant article presents a question-and-answer format discussion focused on evaluation and management reporting in the outpatient setting. It is relevant to coders, billing staff, and clinicians who work with CPT-based E/M services and payer policy variation. The article covers the general scope of the cited E/M code family and the role of third-party payer policies in reporting decisions.

Why This Topic Matters

It helps readers understand the article’s focus on CPT evaluation and management reporting and the fact that payer policies may affect who can report these services.

Article Sections

  1. Coding Consultation: Questions and Answers

    An AMA-style Q&A section addressing a CPT evaluation and management reporting question in the outpatient context.

What You Will Learn

  • The article’s focus within CPT evaluation and management reporting
  • How the Q&A is framed for outpatient visit coding
  • Why payer policy awareness is relevant to this topic
  • Which professional groups the discussion is aimed at

Who Should Read This

  • Medical coders
  • Billing staff
  • Physicians
  • Nonphysician health care professionals
  • Practice managers

Codes Discussed

Code Ranges Discussed


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