Use the follow-up examination only when any class of client is being evaluated during the course of treatment. This examination cannot be billed on the same day as any other examination (except directly observed therapy [DOT] or directly observed preventive therapy [DOPT]). Services may include, but are not limited to, record maintenance, clinical assessment and diagnostic procedures, nonphysician assistance with evaluation, and physician consultation and evaluation.
The following procedure codes and modifiers may be billed for follow-up examinations:
Service
Client Class
Procedure Code/Modifier
Maximum Fee
Follow-Up Exam
Level 01: Nonphysician services only
1 or 2
D-99214 with modifier TF
$22.12
3 or 5
D-99214 with modifier TG
$27.12
Follow-Up Exam
Level 06: Nonphysician and
Physician services
1 or 2
D-99214 with modifiers TF and AM
$46.37
3 or 5
D-99214 with modifiers TG and AM
$51.50
Texas Medicaid & Healthcare Partnership CPT only copyright 2007 American Medical Association. All rights reserved.
