Prior Auth Required

99342 - Home or residence visit for the evaluation and management of a new patient, which requires a medically

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceHome or residence visit for the evaluation and management of a new patient, which requires a medically
Procedure / Service Description

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, - appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded. 99342 Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.