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Level 4 Office Consult (99244)

This is the most popular code used to bill for office consults.  Internists selected the 99244 code for 40% of these encounters in 2003.   To get an idea of the frequency of use of this code among sub-specialists, nephrologists used this level of care for a whopping 49% of consults performed in the office during that same year (which added up to 77,556 visits). The 99244 ranked 46th among the most frequently used CPT codes by all physicians in 2003.  The reimbursement for this level of care is approximately $168.00.  Usually the presenting problems are of moderate to high severity.

The documentation for this encounter requires THREE out of THREE of the following :

1)  Comprehensive History
2)  Comprehensive Exam
3)  Moderate Complexity Medical Decision-Making

Or 60 minutes spent face-to-face with the patient if coding based on time.  The appropriate documentation must be included.

Clinical Example

This topic is covered in more detail in of one of our web-based E/M coding courses.

E/M Consult Services

Consult Services   Related Topics


Basic Course Preview
Although Medicare no longer pays for consult services, some private payers still do. But beware. Auditors love to downcode these visits when doctors don't include the exact right terminology. Learn to get it right.    
  For mutliple users, consider an E/M Comliance Web Portal.


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