99215 Insurance Policy Changes

CPT 99215, in plain terms, covers A doctor's office visit for an established patient involving a high level of medical decision-making and about 40 minutes of care. CPT 99215 is referenced in 50 tracked payer policy changes from MassHealth, CareSource, and 21 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 99215 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 99215 on AAPC