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99395 is a routine exam ("check up") for an adult aged 18-39 who is not new to the practice. The preventive exam codes are broken out by age and by new or established status.

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What is billing code 99395?

Billing code 99395 refers to a preventive medicine evaluation and management service for an established patient, specifically for an annual check-up or wellness visit. This code is typically used for patients aged 18-39 years and involves a comprehensive assessment that includes a physical examination, health history review, and counseling on preventive care. It is part of the Current Procedural Terminology (CPT) codes used by healthcare providers for billing purposes.


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Can you add a modifier 25 to 99395?

Yes, you can add modifier 25 to code 99395. Modifier 25 indicates that a significant, separately identifiable evaluation and management service was performed on the same day as another service. In this case, it would suggest that a comprehensive preventive exam (99395) was conducted alongside an additional evaluation or treatment that warranted separate billing.


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