2023: Home or Residence Services
Home and Residence services underwent CPT changes in 2023. One change, was the merger of Domiciliary, Rest Home (e.g. Boarding Home), or Custodial Care Services into the Home code set. The stand-alone codes were deleted for 2023. Also deleted, was the middle Home Services code, 99343. Now both New and Established categories have (4) codes each.
AMA Definitions:
Home:
- a private residence,
- temporary lodging, or
- short term accommodation (e.g. hotel, campground, hostel, or cruise ship).
Residence:
- an assisted living facility, group home (that is not licensed as an intermediate care facility for individuals with intellectual disabilities),
- custodial care facility, or
- residential substance abuse treatment facility.
AMA CPT Codes:
As you can see here, CPT allows you to level your Home Services either by MDM or Time. The same approved time-based activities that you use for office and facility, also apply to home visits. One word of caution, do not count your travel time. We have created a convenient cheat sheet here. If you report the base service using time, and you exceed 100 minutes, you may append Prolonged Service code(99417) for private pay or Medicaid Patients. Medicare has their own Prolonged Service Threshold times and criteria. More details regarding prolonged services are detailed in the linked resources (below).
If you would like additional information or training, please contact [email protected].