99213: Office or other outpatient visit, established patient, low complexity
99213 is the follow-up medication visit for an established client at low medical decision-making complexity, or 20 to 29 minutes of total time on the date. With 99214 (moderate complexity, 30 to 39 minutes) it is the pair PMHNPs bill for medication management with children and teens.
- Kind
- CPT code
- Family
- em
- Time
- 20 to 29 minutes
- Who bills
- Nurse practitioners
- Telehealth
- Eligible
- Add-on
- Stands alone
When to use it
Use 99213 for a stable follow-up: reviewing response and side effects, adjusting nothing or something minor, and coordinating with the therapist. Choose the level by medical decision-making or by total time, whichever your documentation supports.
When not to
Do not use E/M codes for a visit that was psychotherapy by the prescriber (add 90833, 90836, or 90838 to the E/M when psychotherapy is a distinct part). Do not use 99213 for a new client (99203 to 99205) or the intake (90792).
With children and families
Medication visits with a child are three-way conversations: parent report, the child's own account, and the therapist's notes in the shared record. Document response, side effects, growth and vitals where relevant, school feedback, and the plan. Note the collaborating physician arrangement where your state requires one.
Questions about 99213
- 99213 or 99214?
- 99214 when medical decision-making is moderate (for example a medication change with monitoring) or total time is 30 to 39 minutes; 99213 for low complexity or 20 to 29 minutes.
- Can I add psychotherapy to an E/M visit?
- Yes, with the psychotherapy add-on codes (90833, 90836, 90838) when the therapy is separately documented.
Related
| Code | What it is | Time | Who bills | Telehealth |
|---|---|---|---|---|
| 90792 | Psychiatric diagnostic evaluation with medical services | One unit per evaluation; no time threshold | Nurse practitioners | Yes |
General information for licensed clinicians, not billing advice. Insurers reimburse each code differently and payer contracts control; Emora handles the billing.
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