Home or residence visit for a new patient (60–74 minutes)
CPT® code 99344 is used to report a home or residence visit for the evaluation and management (E/M) of a new patient that requires a moderate level of medical decision-making or involves 60 to 74 minutes of total time on the date of the encounter. This code reflects the time and complexity involved when a qualified healthcare professional provides a comprehensive evaluation and care plan in a patient’s home or residential setting.
When to Use CPT® Code 99344
Report 99344 when:
- The visit takes place in a home, assisted living facility, or residential care setting (not a hospital or nursing facility).
- The patient is new to the provider or the practice.
- The provider performs a comprehensive history and examination and makes moderate-complexity medical decisions.
- The total time spent on the date of service—including preparation, face-to-face interaction, and documentation—is 60 to 74 minutes.
- The encounter involves coordination of care, medication management, or the evaluation of multiple health issues.
Documentation Requirements
To appropriately bill 99344, documentation should include:
- The setting and reason for the home visit
- A comprehensive history (chief complaint, HPI, past/family/social history, and review of systems)
- A detailed examination relevant to the patient’s condition
- Medical decision-making of moderate complexity (e.g., multiple diagnoses, medication adjustments, or management of chronic and acute conditions)
- Total time spent on the encounter, including preparation and follow-up tasks
- A personalized care plan or recommendations discussed with the patient and/or caregivers
Thorough documentation ensures compliance and supports the medical necessity of conducting the evaluation in the home setting.
Billing Guidelines
- 99344 is designated for new patients only; established patient home visits should be billed under codes 99347–99350.
- The code applies to home or residence visits, including private residences, group homes, or assisted living facilities.
- The level of service is determined by either total time or medical decision-making, consistent with 2023 CPT® E/M guidelines.
- Additional services such as vaccinations, laboratory draws, or procedures performed during the same encounter may be reported separately when applicable.
Example
A nurse practitioner visits a new patient in their home to assess uncontrolled diabetes and hypertension. The visit includes a comprehensive history and exam, medication review, and an updated care plan involving diet changes and follow-up coordination with a primary care provider. The total time spent—documentation, counseling, and coordination—equals 65 minutes. The appropriate code for this visit is 99344.
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