99233 Hospital follow-up visit Medicare reimbursement rates in Kansas

This subsequent hospital visit is for a patient receiving inpatient or observation care after the initial hospital encounter. A hospitalist, internist, specialist, nurse practitioner, or physician assistant may assess a worsening condition, adjust treatment, and coordinate care. Situations may include worsening sepsis or heart failure that is not responding to diuresis, but the diagnosis alone does not establish the visit level. An intensivist may report this visit when the work does not meet critical care reporting requirements.

Select 99233 using high medical decision making or at least 50 minutes of the reporting practitioner's total time on the calendar date. Qualifying time can include reviewing records, discussing management with other clinicians, counseling family when appropriate, and documenting the visit; exclude time spent on separately reported services. For medical decision making, documentation must support a high level in two of its three elements, such as problems addressed, data, and management risk. Record total time when selecting by time. The same subsequent-care series covers inpatient and observation stays. CMS reports equal office and facility practice expense values for this code, although most reported Medicare services are in facilities.