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CPT Code 99397- Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older

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What is medical service code 99397?

99397 is the cpt code for an established patient routine/preventative exam (physical) age 65+


Why is medical service code 99397 not paid for?

The physical exam (code 99397) has never been covered by Medicare. Further, the Medicare Annual Wellness Visit (AWV) services clearly do not include an exam.


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Medicare billing for 99397?

CPT code 99397 is used for a preventive medicine visit for patients aged 65 and older, focusing on an annual wellness exam that includes a comprehensive physical examination and preventive services. Medicare covers this service, but patients may be responsible for a coinsurance payment after meeting their Part B deductible. It's essential to ensure proper documentation of medical necessity and preventive services provided during the visit to facilitate billing and reimbursement. Always check the latest Medicare guidelines for any updates or specific billing requirements.


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What is the medical billing code 99284 for?

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