CPT Code 99252: Inpatient or Observation Consultations for a New or Established Patient

No. Medicare does not reimburse CPT consultation codes such as 99252. Instead, Medicare requires providers to use the appropriate initial hospital care codes (99221–99223).

No. Code 99252 specifically applies to initial inpatient consultations. Use subsequent hospital care codes for follow-up care.

No. Billing can be based on either straightforward medical decision-making or a documented minimum of 35 minutes of total time spent on the day of service.

Yes. A formal written report detailing findings and recommendations must be sent back to the referring provider as part of the consultation process.