• Changes in CPT language for 99211


    Has the CPT language for 99211 changed over the past few years?

    Yes. Previously, from 1997 to 2020, CPT description said: Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually the presenting problem(s) are minimal. Typically, 5 minutes spent performing or supervising these services.

    During the public health emergency, Medicare allowed these exemptions: 99211 could be reported “via telemedicine with virtual physician supervision and signature for new and established patients.”
    For 2021, the CPT description says: Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problems(s) are minimal. The time component was removed.

    It’s changing again beginning Jan. 1, 2022: Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional. Level of presenting problem has been removed.

    What else you need to know: The “technician code” in 2022 may be reported for telemedicine as indicated by the star in front of the code. To submit 99211, a physician’s documented order must detail what elements of the exam are medically necessary to perform. This can’t be a standing order, but unique to the needs of the patient. The ordering or supervising physician must be onsite in the office suite. The physician must be onsite in the office suite. The physician must sign off on the chart note because the exam is billed under his or her NPI. All testing services are bundled with 99211 when performed the same day.