CPT Code 99366: Medical Team Conference, With Patient Present

What is CPT code 99366?

CPT code 99366 represents a medical team conference involving healthcare professionals in a face-to-face meeting with the patient and/or family present. This code explicitly covers a medical team conference direct interaction where multiple disciplines collaborate on patient care decisions in real-time.

The 99366 CPT code describes a team conference that brings together an interdisciplinary team of qualified professionals to discuss and coordinate the patient's care plan. Unlike other conference codes that may involve remote participation, this particular team conference requires direct face-to-face contact and physical presence of both the care team and patient.

This team conference code 99366 encompasses several essential elements. The conference with an interdisciplinary team must include participation by non-physician, qualified healthcare professionals alongside physicians. The interdisciplinary team of health care providers typically consists of nurses, social workers, therapists, case managers, and other specialists relevant to the patient's care.

The team conference's  direct face-to-face contact with patient distinguishes this code from telephone-based consultations or phone calls between providers.

Documentation requirements

The medical record must include:

• The date, time, and duration of the medical team conference
• The identification of each healthcare professional present
• The patient and family members who participated, note their level of engagement in care planning discussions.

Clinical documentation must outline the specific health issues addressed, treatment options discussed, and care coordination decisions made during the conference. The management plan resulting from the team meeting should be clearly documented, including any changes to existing treatment protocols or services.

Since this new code requires direct patient involvement, documentation must demonstrate meaningful patient participation rather than passive presence. The record should reflect patient input on treatment preferences, care goals, and any concerns raised during the team conference.

Family member participation, when applicable, should also be documented, including their contributions to care planning and any educational needs addressed during the meeting. This ensures compliance with billing requirements while supporting comprehensive patient-centered care.

Billing guidelines

The code can only be billed when specific criteria are met regarding team composition, meeting duration, and patient participation requirements.

Most payers limit the frequency of team conference billing to ensure appropriate utilization. Medicare typically allows one team conference per patient per 30-day period, though exceptions may apply for patients with complex or rapidly changing conditions.

Some insurance plans may require prior authorization for team conference services, particularly when involving multiple specialties or extended care coordination activities.

Other relevant codes

• CPT code 99367: Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician
• CPT code 99368: Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional