99205 Insurance Policy Changes

CPT 99205, in plain terms, covers A comprehensive first-time visit with a doctor that typically takes about an hour to complete. CPT 99205 is referenced in 48 tracked payer policy changes from CareSource, NC Medicaid - NCDHHS, and 22 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 99205 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 99205 on AAPC