CPT Code 99211 is defined (by the American Medical Association’s CPT Manual) as an evaluation and management (E/M) service for an established patient that may not require the presence of a physician or other qualified healthcare professional. CPT Code 99211 remains one of the most misunderstood and misrepresented services in all of CPT Coding. One of the key requirements is that the encounter must be directed by a physician/QHCP and include actual evaluation and management. CPT Code 99211 should not be reported for telephone calls, injection visits, blood pressure checks, lab draws, etc. Although the physician does not have to “personally” evaluate the patient, direct supervision of ancillary clinical staff is required for billing purposes. In this session, our expert speaker will discuss the appropriate use and application of CPT Code 99211 in 2025, clinical documentation requirements, who can render 99211, redline 99211 case studies together, highlight best practices, and so much more.
Toni Elhoms is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, compliance, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC (ACE). She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Ms. Elhoms’ expertise extends to both inpatient and outpatient coding, compliance, billing, and reimbursement. Ms. Elhoms serves as ACE’s Senior Consultant and conducts training and educational seminars across the country on a variety of topics including, but…