99499 Unlisted evaluation and management service
Also known as: unlisted E&M, unlisted evaluation management
Unlisted evaluation and management service that does not fit standard Evaluation and Management codes; requires special documentation and explanation.
In Plain Language
unusual doctor visit that doesn't fit standard billing codes
Clinical Context
Used for complex or unusual clinical encounters that do not map to established evaluation and management codes, requiring detailed justification.
RVU Information
CPT 99499 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
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
This code has a work RVU of 0.00, meaning it does not have a physician work component assigned by CMS. In the Evaluation & Management category, 8% of codes share this characteristic.
Specialties
Frequently Asked Questions
What is CPT code 99499?
CPT 99499 (Unlisted evaluation and management service) is a Evaluation & Management code. Unlisted evaluation and management service that does not fit standard Evaluation and Management codes; requires special documentation and explanation.
Who uses CPT code 99499?
CPT 99499 is used by All Specialties. Used for complex or unusual clinical encounters that do not map to established evaluation and management codes, requiring detailed justification.
When is CPT 99499 used?
Used for complex or unusual clinical encounters that do not map to established evaluation and management codes, requiring detailed justification.
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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.