These codes are used to report subsequent hospital care services (also known as hospital progress notes). Use these codes to report subsequent hospital care services for both inpatients and observation care patients. There are three levels of care for these services. There is significant variability in payment, depending upon the code billed, so it is important to select the level of care which matches the clinical circumstances of the patient to optimize reimbursement.
For these encounters, the level of care may be selected based on the MDM required for the visit OR based on time spent.
The rules for performing and documenting initial hospital care services are covered extensively in the SUBSEQUENT HOSPITAL CARE course, which includes examples for all three levels of care as well as detailed explanations of the MDM and time required for each visit.
The 99231 level of care for subsequent hospital care services (otherwise known as a level 1 hospital progress note) is the lowest level of care for these encounters. This level of care requires straightforward or low complexity medical decision-making or a total of twenty-five minutes of time spent.
The 99231 level of care is used for about 3.74% of subsequent hospital care services among internists and pays about $44.
The 99232 level of care for subsequent hospital care services (otherwise known as a level 2 hospital progress note) requires moderate complexity medical decision-making or a total of thirty-five minutes of time spent.
The 99232 level of care is used for about 50.1% of subsequent hospital care services among internists and pays about $71.
The 99233 level of care for subsequent hospital care services (otherwise known as a level 3 hospital progress note) is the highest level of care for these encounters. This level of care requires high complexity medical decision-making or a total of fifty minutes of time spent.
The 99233 level of care is used for about 45.6% of subsequent hospital care services among internists and pays about $107.