CPT Code 99235: Inpatient or Observation Care, Same-Day Admit & Discharge, Moderate Complexity

No, CPT code 99235 is not used for emergency department (ED) visits. It is specifically for hospital inpatient or observation care services when the same provider performs both admission and discharge on the same date.

Yes, 99235 can be selected based on either moderate complexity medical decision-making or the total time spent on the date of service. When using time, documentation must show at least 70 minutes of total time spent on face-to-face and non-face-to-face activities related to the patient’s care on that date.

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Multiple providers cannot each bill 99235 for the same patient on the same date. Only a physician or a qualified healthcare professional who performs both admission and discharge services may report 99235. Other providers who see the patient during the stay should report subsequent hospital inpatient or observation care codes (99231–99233) with appropriate documentation.