CPT® Code 98966

Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion

The CPT® Code 98966 refers to a telephone assessment and management service that is conducted by a nonphysician qualified health care professional for an established patient, parent, or guardian. This service is initiated by the patient or their representative and involves a medical discussion lasting between 5 to 10 minutes. It is important to note that this telephone service must not be related to any assessment and management service that occurred within the previous 7 days, nor should it lead to any subsequent assessment and management service or procedure within the next 24 hours or the soonest available appointment. The professionals who can provide this service include registered dieticians, physical therapists, occupational therapists, and speech-language pathologists. During the call, the health care professional engages with the patient by listening to their concerns, answering questions, and providing necessary counseling and instructions. They may also modify the treatment plan based on the discussion. Documentation of the conversation, including the time spent, is required in the medical record to ensure proper coding and billing. For longer discussions, there are additional codes available: 98967 for 11-20 minutes and 98968 for 21-30 minutes.