Pediatric CPT Codes for 2023 + Modifiers

If your pediatric practice’s codes aren’t accurate or up-to-date, you could be missing out on collections with your medical billing. Inaccuracy can also delay claims processing, so it’s important to stay on top of the latest codes.

Pediatric CPT Code Ranges for 2023

The following codes are the latest for pediatric CPT codes in 2023:

• 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 2023:

• 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 – under-immunized 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

Learn more in our Pediatric medical billing services.

For informational purposes only.