2006 Care Plan Oversight Codes 99339-99340

How are physicians compensated for time spent in care plan development and oversight for patients cared for in their homes by family members or in an assisted living facility?

New in 2006, are codes allowing physicians to report 15 minutes or more within a calendar month of physician care plan oversight for patients not enrolled in home health or hospice and not in a nursing facility. Codes 99339 and 99340 report development of complex and multidisciplinary care modalities and/or revision of care plans, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s)(e.g. legal guardian) and /or key caregiver(s) involved in the patient’s care, integration of new information into the medical treatment plan and/or adjustment of medical therapy.

These codes may be overlooked as they are not found in the section of Care Plan Oversight Services but are found following the codes for domiciliary or rest home visits to established patients. Note in CPT the parenthetical directing physicians to see the instructions for codes 99339 and 99340 in the introductory notes to codes 99374-99380 (the care plan oversight codes for home health, hospice and nursing facility patients.)

These codes should be considered for services to chronically ill children cared for in their homes without home health care and who require physician coordination with their schools, therapists, other physicians or psychologists. Also, consider the Down’s syndrome or Alzheimer's patient for whom you coordinate care with other healthcare providers, vocational or daycare programs, or in-home caregivers. It is likely that you have a patient or two for whom you provide this service. Now you have codes for reporting it.