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99381 initial pm e/m new pat infant

Evaluation & Management

Also known as: preventive exam infant, well baby visit, preventive care newborn

Initial comprehensive preventive medicine evaluation and management of an individual including age and gender appropriate history, examination, counseling, and risk factor reduction interventions, established patient; infant (less than 1 year).

In Plain Language

Baby health check-up; Infant preventive visit

Clinical Context

Used for comprehensive preventive care visit with an infant less than 1 year of age, including developmental assessment, immunization review, and anticipatory guidance.

RVU Breakdown

Work RVU1.50
Total RVU1.50

Est. Medicare Payment

$50.10

National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).

Billing & Documentation

E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.

How This Code Compares

With a work RVU of 1.50, this code ranks in the 50th percentile among Evaluation & Management codes — 1.0x below the median (1.54). The highest wRVU in this category is 18.46.

Specialties

Family MedicinePediatricsInternal Medicine

Frequently Asked Questions

What is CPT code 99381?

CPT 99381 (initial pm e/m new pat infant) is a Evaluation & Management code. Initial comprehensive preventive medicine evaluation and management of an individual including age and gender appropriate history, examination, counseling, and risk factor reduction interventions, established patient; infant (less than 1 year).

Who uses CPT code 99381?

CPT 99381 is used by Family Medicine, Pediatrics, Internal Medicine. Used for comprehensive preventive care visit with an infant less than 1 year of age, including developmental assessment, immunization review, and anticipatory guidance.

When is CPT 99381 used?

Used for comprehensive preventive care visit with an infant less than 1 year of age, including developmental assessment, immunization review, and anticipatory guidance.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.