Pediatric CPT Codes for 2022 + Modifiers

When it comes to processing claims, accuracy is essential. Using the wrong codes or codes that are too general could delay the claims process and result in less profit. Increase your pediatric practice’s collections by staying up-to-date with the latest CPT codes and modifiers.

Pediatric CPT Code Ranges for 2022

The following codes are the latest for pediatric CPT codes in 2022:

• 99381 – new patient preventative care for infant
• 99382 – new patient preventative care for 1-4 years old
• 99383 – new patient preventative care for 5-11 years old
• 99384 – new patient preventative care for 12-17 years old
• 99385 – new patient preventative care for 18+ years old
• 99391 – established patient preventative care for infant
• 99392 – established preventative care for 1-4 years old
• 99393 – established preventative care for 5-11 years old
• 99394 – established preventative care for 12-17 years old
• 99395 – established preventative care for 18+ years old
• 99401 – 15 minute counseling for preventative medicine or risk reduction
• 99402 – 30 minute counseling for preventative medicine or risk reduction
• 99403 – 45 minute counseling for preventative medicine or risk reduction
• 99404 – 60 minute counseling for preventative medicine or risk reduction
• 99411 – 30 minute counseling for preventative medicine or risk reduction for a group
• 99411 – 60 minute counseling for preventative medicine or risk reduction for a group
• 99211 – office visit that doesn’t require a qualified health professional
• 99491 – chronic care management, first 30 minutes
• 99437 – chronic care management, each additional 30 minutes
• 99487 – complex chronic care management, first 30 minutes
• 99489 – complex chronic care management, each additional 30 minutes
• 99424 – principal care management for a high-risk disease, first 30 minutes
• 99425 – principal care management for a high-risk disease, each additional 30 minutes
• 99426 – principal care management for a high-risk disease, first 30 minutes
• 99427 – principal care management for a high-risk disease, each additional 30 minutes

Pediatric CPT Modifiers

The following CPT modifiers are for pediatric care in 2022:

• Z00.110 – newborn under 8 days old health supervision
• Z00.111 – newborn between 8 and 28 days old health supervision
• Z00.121 – routine health exam for a child with abnormal findings
• Z00.129 – routine health exam for a child with no abnormal findings
• Z00.00 – routine health exam for an adult with no abnormal findings
• Z00.01 – routine health exam for an adult with abnormal findings
• Z28.3 – underimmunized status
• Z71.3 – dietary counseling or surveillance
• Z71.82 – exercise counseling
• Z71.84 – health counseling for travel purposes
• Z71.85 – counseling for immunization safety
• Z71.89 – other counseling, specified
• Z71.9 – other counseling, unspecified

For informational purposes only.