98966 Telephone assessment Medicare reimbursement rates in Missouri

This code describes a brief telephone conversation in which a nonphysician qualified health care professional assesses and manages a clinical concern for an established patient, or the patient’s parent or guardian. A nurse practitioner or physician assistant might use it to address a symptom question or discuss a care issue that can be managed by phone. The service involves clinical judgment, not simply scheduling, relaying a routine message, or providing administrative information. It is a telephone service, not an exchange through an online patient portal.

Select this level when the documented service time is 5 through 10 minutes; use the longer time levels when the conversation meets their thresholds. The record should identify the concern, the assessment or management provided, and the time spent. CPT reporting conditions also require that the call not arise from a related assessment and management service in the previous seven days or lead to a related service or procedure within the next 24 hours or soonest available appointment. CMS assigns work, practice-expense, and malpractice values, with separate office and facility practice-expense inputs.