Outpatient Encounter

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  "date" : "2023-11-16T01:09:13-05:00",
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  "purpose" : "(Clinical Focus: The purpose of this value set is to represent concepts for encounters for outpatient visits.),(Data Element Scope: This value set may use a model element related to Encounter.),(Inclusion Criteria: Includes concepts that represent an encounter for comprehensive history, evaluation, and management of a patient in an outpatient setting.),(Exclusion Criteria: No exclusions.)",
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      "code" : "99202",
      "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99203",
      "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99204",
      "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99205",
      "display" : "Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99211",
      "display" : "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",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99212",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded.",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99213",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99214",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99215",
      "display" : "Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99242",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99243",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99244",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99245",
      "display" : "Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99341",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99342",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99344",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99345",
      "display" : "Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99347",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99348",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99349",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99350",
      "display" : "Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99381",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99382",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99383",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99384",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years)",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99385",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99386",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99387",
      "display" : "Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99391",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99392",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99393",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99394",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99395",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99396",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99397",
      "display" : "Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99401",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99402",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99403",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99404",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99411",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99412",
      "display" : "Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99429",
      "display" : "Unlisted preventive medicine service",
      "version" : "2025"
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      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99455",
      "display" : "Work related or medical disability examination by the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99456",
      "display" : "Work related or medical disability examination by other than the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report.",
      "version" : "2025"
    }, {
      "system" : "http://www.ama-assn.org/go/cpt",
      "code" : "99483",
      "display" : "Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: Cognition-focused evaluation including a pertinent history and examination, Medical decision making of moderate or high complexity, Functional assessment (eg, basic and instrumental activities of daily living), including decision-making capacity, Use of standardized instruments for staging of dementia (eg, functional assessment staging test [FAST], clinical dementia rating [CDR]), Medication reconciliation and review for high-risk medications, Evaluation for neuropsychiatric and behavioral symptoms, including depression, including use of standardized screening instrument(s), Evaluation of safety (eg, home), including motor vehicle operation, Identification of caregiver(s), caregiver knowledge, caregiver needs, social supports, and the willingness of caregiver to take on caregiving tasks, Development, updating or revision, or review of an Advance Care Plan, Creation of a written care plan, including initial plans to address any neuropsychiatric symptoms, neuro-cognitive symptoms, functional limitations, and referral to community resources as needed (eg, rehabilitation services, adult day programs, support groups) shared with the patient and/or caregiver with initial education and support. Typically, 60 minutes of total time is spent on the date of the encounter.",
      "version" : "2025"
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    "timestamp" : "2024-12-10T10:24:00-05:00"
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