CPT/HCPCS Section

Evaluation and Management (E/M)

94 procedure codes with Medicare Physician Fee Schedule payment data. Click a code for Facility vs Non-Facility rates, allowed amounts and utilization.

99202New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more$3899203New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$6399204New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more$10299205New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more$14599211Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional$1299212Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$3199213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$5299214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$7599215Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more$11499221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes$6199222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes$9799223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes$13099231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes$3699232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes$5999233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes$8999234Initial hospital care with same-day admission and discharge with straightforward or low level of medical decision making, per day, if using time, at least 45 minutes$7199235Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes$11499236Initial hospital care with same-day admission and discharge with high level of medical decision making, per day, if using time, at least 85 minutes$15399238Hospital discharge day management, 30 minutes or less$6099239Hospital discharge day management, more than 30 minutes$8699281Emergency department visit for problem that may not require health care professional$899282Emergency department visit with straightforward medical decision making$2899283Emergency department visit with low level of medical decision making$5199284Emergency department visit with moderate level of medical decision making$8699285Emergency department visit with high level of medical decision making$13299291Critical care, first 30-74 minutes$17099292Critical care, each additional 30 minutes$8699304Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes$5999305Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes$9899306Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more$13599307Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes$2999308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more$5399309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes$7499310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes$10699315Nursing facility discharge day management, 30 minutes or less$5899316Nursing facility discharge management, more than 30 minutes$9199341Residence visit for new patient with straightforward medical decision making, per day, if using time, at least 15 minutes$3599342Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes$5799344Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes$9799345Residence visit for new patient with high level of medical decision making, per day, if using time, at least 75 minutes$13699347Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes$3099348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes$5399349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes$8899350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes$12899406Smoking and tobacco use intensive counseling, 4-10 minutes$1299407Smoking and tobacco use intensive counseling, more than 10 minutes$2599415Extended office or other outpatient service by clinical staff, first hour$1799416Extended office or other outpatient service by clinical staff, each additional 30 minutes$699421Online digital evaluation and management service for an established patient for up to 7 days, total time 5-10 minutes$1099422Online digital evaluation and management service for an established patient for up to 7 days, total time 11-20 minutes$2099423Online digital evaluation and management service for an established patient for up to 7 days, total time 21 or more minutes$3299424Principal care management services for a single high-risk disease, first 30 minutes provided personally by qualified health care professional, per calendar month.$6099425Principal care management services for a single high-risk disease, each additional 30 minutes provided personally by qualified health care professional, per calendar month$4399426Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month$4199427Principal care management services for a single high-risk disease, each additional 30 minutes of clinical staff time directed by health care professional, per calendar month$3199437Chronic care management services for two or more chronic conditions, additional 30 minutes provided personally by health care professional, per calendar month$4099439Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month$3199441Telephone medical discussion with physician, 5-10 minutes$3099442Telephone medical discussion with physician, 11-20 minutes$5399443Telephone medical discussion with physician, 21-30 minutes$7999446Telephone, internet, or electronic health record assessment and management with verbal and written report by consulting physician, 5-10 minutes$1399447Telephone or internet assessment with verbal and written report by consulting physician, 11-20 minutes$2699448Telephone or internet assessment with verbal and written report by consulting physician, 21-30 minutes$3999449Telephone or internet assessment with verbal and written report by consulting physician, more than 30 minutes$5499451Telephone, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes$2699452Telephone or internet referral service, 30 minutes$2499453Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment$1699454Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days$3799457Management using the results of remote vital sign monitoring per calendar month, first 20 minutes$3099458Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes$2699459Pelvic exam$1699462Follow-up hospital care of newborn per day$2899463Initial inpatient hospital or birthing center same date care and discharge of newborn$8899471Initial inpatient hospital critical care of infant or young child per day (29 days to 2 years)$57699472Follow-up inpatient hospital critical care of infant or young child per day (29 days to 2 years)$30399473Education and training to self measure blood pressure$1199474Self measured blood pressure measurements$999475Initial inpatient hospital critical care of infant or young child per day (2-5 years)$43499476Follow-up inpatient hospital critical care of infant or young child per day (2-5 years)$26399479Follow-up intensive care of recovering low birth weight infant per day$9499483Assessment of and care planning for patient with impaired thought processing, typically 60 minutes$16499484Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional$3699487Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month$8299489Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month$4699490Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month$4099491Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month$5999492Initial psychiatric collaborative care management, first calendar month, first 70 minutes$9399493Follow-up psychiatric collaborative care management, subsequent calendar month, first 60 minutes$8999494Psychiatric collaborative care management per calendar month, each additional 30 minutes$3899495Transitional care management services for problem of at least moderate complexity$11999496Transitional care management services for problem of high complexity$16799497Advance care planning, first 30 minutes$6099498Advance care planning, each additional 30 minutes$5299499Other evaluation and management service$80