Preventive Care Avg. $185

CPT 99387: Preventive Visit, New Patient, Age 65+

Initial comprehensive preventive medicine evaluation and management of a new patient, age 65 years and older.

Why CPT 99387 Claims Get Denied

Claims billed under CPT 99387 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.

Medicare uses IPPE/AWV codes instead of 99387

Frequency limit exceeded

Not covered under Medicare (use G0438/G0439 for AWV)

Missing appropriate diagnosis code

Billing Tips for CPT 99387

For Medicare patients, use G0402 (IPPE) or G0438/G0439 (Annual Wellness Visit) instead. Commercial payers may accept 99387. Always verify which code the payer requires for seniors. Bill separately for any problem-focused E/M with modifier 25.

Documentation Requirements

To support a clean claim for CPT 99387, your clinical documentation should include:

Comprehensive geriatric history

Complete physical examination

Functional assessment

Fall risk assessment

Cognitive screening

Medication reconciliation

Advance care planning discussion

Common Modifiers for CPT 99387

Modifier 25
Modifier 33

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