CPT Code 99341: Home Visit for Evaluation and Management, 15 Minutes

CPT code 99341 covers home or residence E/M visits for new patients, requiring 15 minutes or straightforward medical decision making.

Use Code

What is the CPT Code 99341?

CPT code 99341 is used to report a medically necessary evaluation and management services conducted during a face-to-face visit with a new patient in their private residence or similar home, such as an assisted living facility, boarding home, rest home, or group home not licensed as an intermediate care facility. This code applies specifically to new patients and requires a problem-focused history and examination, accompanied by straightforward medical decision making.

Alternatively, it can be billed when the provider spends a minimum of 15 minutes on the encounter, including all related time spent on the same date. CPT 99341 is commonly used when patients require initial care in a home setting due to limited mobility, intellectual disabilities, or chronic conditions that make travel difficult. It supports medical necessity in home visits where only minimal health care or custodial care services are otherwise available. This service code falls under the category of home or residence services, also known as residence services.

CPT code 99341 documentation requirements

Documentation must include:

Patient's home or qualifying residence (e.g., private home, assisted living facility, boarding home, group home not licensed as an intermediate care facility, custodial care facility, residential substance abuse treatment facility, or rest home providing only minimal health care)
Billing provider must be physically present during the visit; services cannot be billed under "incident to" rules; only the physician or qualified non-physician provider may report the service
Patient must be new to the provider or group practice; this distinguishes it from established patient home services
Problem-focused history and examination
Straightforward medical decision making, or at least 15 minutes of total provider time on the date of service
Time documentation (if billing by time). Include total time spent on preparation, face-to-face interaction, and related follow-up (excluding travel and separately billable services); if applicable, report prolonged services using appropriate add-on codes
Medically necessary, face-to-face evaluation and management encounter
Complete and legible documentation, consistent with standard evaluation and management e guidelines followed in medical practices

CPT code 99341 billing guidelines

Keep in mind the following when billing:

Use for new patients only (not seen by provider/group within 3 years).
Cannot be reported with office E/M or facility codes on the same day.
May be paid differently by Medicare (especially under home health episodes).
Modifier 25 may be used if a procedure is performed on the same date.

Other relevant CPT codes

99347-99350 – Home visit, established patient
99342–99345 – Other new patient home visits

Frequently asked questions

99341 cannot be billed for telehealth services because it is designated for in-person home or residence visits requiring the provider’s physical presence.

It is defined as involving straightforward medical decision making, typically addressing a single self-limited or minor problem, with minimal data to review and low risk of complications or morbidity. The visit usually involves a problem-focused history and exam and about 15 minutes of total time spent face-to-face with the patient in their home or residence.

Yes, nurse practitioners (NPs) and physician assistants (PAs) can bill CPT code 99341, provided they are practicing within the scope of their state law and meet all other billing requirements for home or residence visits. These codes are not limited to physicians and include qualified non-physician practitioners (NPPs) such as NPs and PAs.