What is the CPT code 99220?

Established Patient Initial Hospital Observation Care Services
CPT® 99220, Under New or Established Patient Initial Hospital Observation Care Services. The Current Procedural Terminology (CPT®) code 99220 as maintained by American Medical Association, is a medical procedural code under the range – New or Established Patient Initial Hospital Observation Care Services.

What place of service is used for 99220?

Initial Observation Care codes (99218 – 99220) are used to report E&M services provided to patients designated/admitted as “observation status” in a hospital to determine whether they warrant admission, transfer, or discharge. Only the physician initiating observation status may report these codes.

Is CPT 99220 inpatient or outpatient?

Initial Hospital Observation Service CPT codes 99218 – 99220 describe the first visit of the patient’s admission for outpatient hospital observation care by the Admitting/Supervising Physician or Other Qualified Health Care Professional.

Who can Bill 99220?

the physician
Initial Observation Care (CPT code range 99218-99220) When a patient receives observation care for less than 8 hours on the same calendar date, the Initial Observation Care, from CPT code range 99218 – 99220, shall be reported by the physician.

How many RVU is 99220?

7.27 RVU
The combined RVUs for these code pairs would be as follows: 4.87 for 99218 and 99217; 5.88 for 99219 and 99217; or 7.27 RVU for 99220 and 99217.

Does Medicare pay for observation codes?

Medicare will not pay separately for any hours a beneficiary spends in observation over 24-hours, but all costs beyond 24-hours will be included in the composite APC payment for observation services.

How Does Medicare pay observation claims?

Outpatient Observation Status is paid by Medicare Part B, while inpatient hospital admissions are paid by Part A. Thus, Medicare beneficiaries who are enrolled in Part A, but not Part B, will be responsible for their entire hospital bill if they are classified as Observation Status.