E/M Consultation Services

Aka: E/M Consultation Services, E/M Consultation, CPT 99241, CPT 99242, CPT 99243, CPT 99244, CPT 99245

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II. Indication

  1. Outpatient Consultation

III. Outpatient Consultation: CPT Code 99241

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Problem Focused History
    2. E/M Problem Focused Exam
    3. E/M Straightforward Medical Decision
  2. E/M Self Limited or Minor Problem
  3. Physician Time: 15 minutes

IV. Established Outpatient: CPT Code 99242

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Expanded Problem Focused History
    2. E/M Expanded Problem Focused Exam
    3. E/M Straightforward Medical Decision
  2. E/M Low Severity Problem
  3. Physician Time: 30 minutes

V. Outpatient Consultation: CPT Code 99243

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Detailed History
    2. E/M Detailed Exam
    3. E/M Low Complexity Medical Decision
  2. E/M Moderate Severity Problem
  3. Physician Time: 40 minutes

VI. Outpatient Consultation: CPT Code 99244

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Comprehensive History
    2. E/M Comprehensive Exam
    3. E/M Moderate Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 60 minutes

VII. Outpatient Consultation: CPT Code 99245

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Comprehensive History
    2. E/M Comprehensive Exam
    3. E/M High Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 80 minutes

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