CPT Code 99211: Evaluation and Management – Established Patients

Procedure Code 99211 is a great but commonly disregarded code used by ancillaries to psychiatrists. Read below to get more info on when to use the code for billing, and how to apply the code for great reimbursement.

CPT Code 99211: Evaluation and Management Description

CPT Code 99211 is an insurance billing procedure code describing evaluation and management at an office or outpatient visit with an established patient.

This code can be used by an ancillary of the client’s psychiatrist and billed as if the psychiatrist were performing to visit. Be careful to state the relationship between the provider of the service and the psychiatrist, otherwise the claim may be denied.

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If you’re struggling to figure out the right CPT codes to use for your mental health insurance claims, consider hiring our billing service to help.

CPT Code 99211 Time Length

Procedure code 99211 is considered an evaluation and management visit lasting five minutes or less.

CPT Code 99211(Source)

For more information on other psychiatric CPT codes, check out our guide.

99211 vs 99212 vs 99213

Code use depends on severity of symptoms, as well as physician’s presence. Use code 99211 when the symptoms are mild and an ancillary of the physician is evaluating and managing. The primary use of 99211 CPT code is for staff in relation to the physician, not the physician themselves.

99212 and 99213 should be used if the symptoms are more severe, the visit takes longer, and if there are multiple elements used in evaluation of the patient.

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For more information on code differentiation, check out our Psychiatry Cheat Sheet.

99211 Reimbursement Rates

99211 Reimbursement Rate

Medicare will reimburse for this code at $23.46 by Medicare.

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Does Medicare Approve 99211?

Yes, Medicare considers this routine. If you are an approved Medicare provider you can bill this code.

If you’d like help with your billing, TheraThink can help.

How Frequently Can 99211 Be Billed for a Client?

You can bill for 99211 as frequently as insurance allows, as the code applies to established patient’s evaluation and management.

It’s important to check your patient’s insurance for frequency of CPT codes. If you need help, don’t hesitate to reach out for billing assistance!

What’s the benefit?

CPT code 99211 is beneficial to bringing in additional revenue when used correctly. Generally, this is easy revenue to bring to your practice if you remember to bill for it. Additionally, code 99211 does not have any key-component documentation requirements.

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However, if you are looking to take the guess work out of billing, there are other options.

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