Billing CPT 99211 in 2025: What Qualifies, What Doesn’t, and Why It Matters

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 today’s session, we 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.

Webinar Objectives

Led by industry expert Toni Elhoms, this session will provide a comprehensive overview of CPT Code 99211 as it applies in 2025. Attendees will gain clarity on proper usage, clinical documentation requirements, and the types of healthcare professionals authorized to report this code. The session will also explore common pitfalls, services that do not qualify for 99211, and walk through real-world case studies to reinforce key concepts. Whether you're new to 99211 or need a refresher, this session will equip you with the practical insights needed to ensure accurate and compliant reporting.

Webinar Agenda

• Understand the correct use and application of CPT Code 99211 in 2025
• Identify clinical documentation requirements necessary to support 99211 billing
• Determine which healthcare professionals are authorized to report CPT Code 99211
• Distinguish between services that qualify and do not qualify for 99211 billing
• Analyze real-world use cases to reinforce proper application of CPT Code 99211

Webinar Highlights

• Outline the appropriate use and application for CPT Code 99211 in 2025
• Review the clinical documentation requirements for CPT Code 99211 in 2025
• Identify which healthcare professionals are authorized to report 99211
• Review the supervision requirements for CPT Code 99211 in 2025
• Break down the “incident to” billing concept and its relation to 99211
• Review relevant case studies that showcase inappropriate use of CPT Code 99211
• Review relevant case studies that showcase appropriate use of CPT Code 99211
• Outline best practices for compliantly supporting CPT Code 99211

Who Should Attend

• Medical Coding Specialists
• Medical Billing Specialists
• Medical Auditing Specialists
• Private Practice Physicians
• Managed Care Professionals
• Operations Leadership
• Practice Administrators
• Office Managers
• Compliance Officers/Committees  
• Chief Medical Officer