99214 is a reimbursement code for physician services which complies with the following requirements:

(1) The patient is an established one–i.e., it is not their first visit.

(2) It must be an outpatient visit, meaning it must not incorporate a day of hospital time.

(3) It must include the following three points:

• A detailed medical history,

• A detailed medical exam, and

• A medical decision that entails moderate complexity.

(4) The severity of the problem that brings the patient to the clinic must be of moderate to high severity

(5) The doctor and patient should have up to 25 minutes face time.

The US Department of Health and Human Services published an analysis of physician behaviour, finding that from 2001 to 2010, physicians increased their use of higher-level–and more lucrative–billing codes 99214 instead of 99213–for evaluation and management (E/M) services while treating Medicare patients. Experts suggest this is due to more accurate coding based on use of electronic health records rather than (unethical) “up-coding.”

Reference MedspeakUS http://wiki.answers.com/Q/What_does_medical_service_code_99214_stand_for


99214 is also a zip code for Spokane, Washington (see map)  


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