CPT Code 99307: Subsequent Nursing Facility Care, Low Complexity, 10 Minutes

Learn how CPT code 99307 applies to low-complexity nursing facility care for ongoing patient evaluation and management.

What is CPT code 99307?

CPT code 99307 is used to report subsequent nursing facility care for an established patient in a skilled nursing facility (SNF) or other long-term care settings. This code applies to evaluation and management (E/M) services provided during a follow-up visit or ongoing management of patients and involves straightforward medical decision making.

According to CPT guidelines, 99307 typically reflects approximately 10 minutes of total time spent by the physician or qualified healthcare provider on the date of the encounter. This time includes face-to-face care as well as non-face-to-face activities such as reviewing records and coordinating care.

Common scenarios for using CPT 99307 include:

Routine medication management
Monitoring stable chronic conditions
Fall risk assessments
Minor wound care
Reviewing nursing staff notes and lab results

This code is part of the ongoing care required to maintain health stability and support continuity of care of patients in a nursing facility.

CPT code 99307 documentation requirements

To support accurate documentation and compliance with nursing facility billing standards, the medical record must reflect:

Reason for visit and interval medical history
Focused physical examination of affected systems
Review of vital signs, medications, and progress notes
Assessment showing low complexity medical decision making
Clear plan of care, including any adjustments or continued monitoring

Healthcare providers should use structured formats (e.g., SOAP or E/M template) to show the required components for this facility care low complexity service.

CPT code 99307 billing guidelines

Follow these nursing facility services CPT billing rules:

Report only one subsequent visit per day, per patient, per provider.
CPT 99307 cannot be billed on the same date as an initial visit, discharge services, or other facility services CPT code reported for the same patient.
Use the correct Place of Service (POS) codes.
This code is not applicable to domiciliary or assisted living facilities.
Each service must meet the criteria of medical necessity and go beyond routine administrative tasks.

Frequently asked questions

Subsequent nursing facility care falls under the evaluation and management (E/M) category of CPT coding. It includes codes like 99307, which is considered a billing unit for subsequent visits.

These visits represent follow-up care by healthcare providers within nursing facility services, focusing on patients with ongoing medical needs.

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CPT 99307 is designed for low complexity medical decision-making and supports the facility capturing the nuances of continued patient care. The documentation should reflect a detailed interval history, brief physical findings (not a comprehensive exam), and medical decision-making appropriate to stable or improving conditions. This helps ensure accurate representation of the services provided during the visit.

No. CPT 99307 should not be reported on the same day as discharge codes like 99315 or 99316. Providers must choose the most appropriate code based on the service performed. It's important to consider these key points to avoid coding conflicts and ensure proper billing.