CPT® code 99382 is used to report an initial comprehensive preventive medicine evaluation and management (E/M) visit for a new patient aged 1 through 4 years. This service is typically provided in outpatient settings, including pediatric, family medicine, and integrative wellness clinics.
What is CPT Code 99382?
CPT 99382 covers a well-child preventive visit for toddlers and preschool-aged children. The service includes a comprehensive history and physical examination, as well as age-appropriate anticipatory guidance, risk factor screening, and immunization review.
This is a non–problem-focused visit intended to support early childhood development, track milestones, and address family education. It typically includes:
- Growth and developmental screening
- Nutrition and physical activity assessment
- Review of sleep patterns, behavior, and safety
- Immunization status check and planning
- Family health education and counseling
Unlike sick visits, this service is preventive in nature and is not intended to address acute medical concerns—though any findings may lead to a follow-up evaluation.
When to Use CPT Code 99382
Use CPT 99382 when providing a comprehensive, age-appropriate preventive care visit to a new pediatric patient aged 1–4 years. This is typically billed at the time of a child’s 12-, 15-, 18-, 24-, 30-, or 36-month well visits, depending on the clinic's schedule and the child’s needs.
Documentation should reflect:
- A complete developmental and behavioral assessment
- Screening for conditions such as lead exposure, anemia, or autism (as applicable)
- Review and documentation of growth charts, vital signs, and head circumference
- Family history updates and social determinants of health (SDOH)
- Any education or anticipatory guidance provided to caregivers
Coding Considerations
- Do not use 99382 to report problem-focused or sick visits; use the appropriate E/M code (e.g., 99203) instead.
- This code applies only to new patients; for returning children aged 1–4, use CPT 99392.
- Time is not a key factor in billing this code—comprehensiveness of the service is.
CPT 99382 and Preventive Pediatric Care
Early childhood preventive visits are essential for tracking developmental progress, identifying potential concerns, and equipping caregivers with guidance to promote healthy growth. Payers typically cover this code under routine pediatric wellness benefits, often with no patient cost-sharing.
To reduce denials, practices should ensure accurate documentation of developmental screening, immunization history, and counseling topics discussed. Tools such as validated screeners (e.g., ASQ, M-CHAT) can help support the service provided.
Power Preventive Pediatric Visits with OptiMantra
For practices offering pediatric or family-centered care, managing complex wellness visit documentation and age-specific screening requirements can be challenging. OptiMantra simplifies this process with:
- Preloaded templates for well-child visits by age group
- Integrated growth chart plotting and milestone tracking
- Immunization and supply inventory tracking for pediatric vaccines
- Time-saving smart charting that aligns with CPT and ICD-10 standards
- Insurance eligibility verification for preventive services
With OptiMantra, clinicians can deliver more thorough, compliant, and efficient pediatric preventive care—ensuring that every visit counts toward better outcomes and smoother reimbursements.
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