What are the proper CPT codes for an initial and subsequent visits for in-patient hospital and ER patients?
Below are the acceptable E&M codes that are payable for inpatient or ER services:
Initial Inpatient Hospital Visits:
99221: (Low complexity initial hospital visit, 30 minutes)
99222: (Moderate complexity initial hospital visit, 50 minutes)
99223: (High complexity initial hospital visit, 70 minutes)
Subsequent Inpatient Hospital Visits:
99231: (Low complexity subsequent hospital visit, 15 minutes)
99232: (Moderate complexity subsequent hospital visit, 25 minutes)
99233: (High complexity subsequent hospital visit, 35 minutes)
Inpatient Hospital Consultations (Only payable by some commercial HMOs- not for Medicare use):
99251: (Initial inpatient hospital consultation of a new or established patient, minor/self-limited, 20 minutes)
99252: (Initial inpatient hospital consultation of a new or established patient, low complexity, 45 minutes)
99253: (Initial inpatient hospital consultation of a new or established patient, moderate complexity, 55 minutes)
99254: (Initial inpatient hospital consultation of a new or established patient, moderate/high complexity, 80 minutes)
99255: (Initial inpatient hospital consultation of a new or established patient, high complexity, 110 minutes)
Emergency Room Visits:
99281: (Emergency room visit, self-limited/minor)
99282: (Emergency room visit, low/moderate severity)
99283: (Emergency room visit, moderate severity)
99284: (Emergency room visit, moderate/high severity)
99285: (Emergency room visit, high severity)