Current Procedural Terminology (CPT®) code 99211 (office or outpatient evaluation and management [E/M] service, established patient visit) is commonly referred to as a “nurse visit” because the descriptor states that the service “…may not require the presence of a physician. Usually the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.” The Table below shows the financial effect of reporting nurse visits.

Code 99211 is not normally reported for physician services. When the physician provides a face-to-face E/M service, it usually requires (at a minimum) straightforward medical decision-making with a problem-focused history and physical examination. That level of E/M service performed on an established patient would be more appropriately reported with code 99212. Although a physician can report code 99211 when he or she feels it appropriate, services most often performed by non-advanced practice nonphysician providers (NPPs) (eg, nurses, medical assistants, clinical staff) under the...

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