CPT 99211 is commonly referred to as the "nurse visit" code. It is an Evaluation and Management (E/M) service that may not require the presence of a physician or other qualified healthcare professional.
Billing Requirements for 99211
Unlike 99212-99215, code 99211 does not have specific Time or Medical Decision Making (MDM) requirements. However, it still requires a face-to-face encounter and clinical documentation of the service provided (e.g., a blood pressure check or medication review).
| CPT Code | Provider | Time Required |
|---|---|---|
| 99211 | Clinical Staff (RN, MA) | None (Usually ~5 mins) |
"Incident-To" Guidelines
To bill 99211 to Medicare under the physician's NPI, the service must meet Incident-To requirements. This means the physician must provide "direct supervision" (they must be present in the office suite and immediately available, though not necessarily in the exam room).
NCCI Bundling Warnings
Do not bill 99211 for routine venipuncture (36415) or simple injections (96372) unless a separately identifiable E/M service was also performed and documented. NCCI edits will bundle 99211 into most minor procedures.