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Thread: Cpt Code For Family Consultation

  1. #1

    Default Cpt Code For Family Consultation

    AAPC: Back to School
    What E/m Code Do We Use For A Family Consultation Between Physician And Family Member If Patient Is Not Present.

  2. #2


    You could use 99499 Unlisted E&M service. Medicare will not pay for this, and I don't think any other insurance company will either. Either the family member pays for this out of their pocket or the physician does not charge for this service.

  3. #3


    Has there been any update to this question? The question was posted in 2007 and no new information was given in 2008. It seems we would be able to bill for the physician's time.

    Thank you.

    Trudy A. Carmany, CPC
    Cardiac Consultants, PC

  4. #4
    Join Date
    Apr 2007


    We billed an E/M based on time to non-Medicare payers since CPT says, "Physicians typically spend ___ minutes face-to-face with the patient and/or family." Medicare doesn't cover visits for a patient when there is no face-to-face with the patient.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

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