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CPT Code 99231: 2026 Billing, MDM, Time and Documentation Guide

CPT code 99231 subsequent hospital care billing 2026 hero banner: straightforward or low MDM requiring two of three elements versus the 25-minute time threshold, 99231 low versus 99232 moderate versus 99233 high comparison, per-day billing limits for same specialty and group, POS 21 inpatient versus POS 22 observation, and the discharge-date conflict with 99238 and 99239, from ClaimMax RCM.

CPT code 99231 remains active in 2026. It reports subsequent hospital inpatient or observation care, the visit a physician or qualified healthcare professional bills after the first day of a hospital stay but before discharge. The code supports straightforward or low medical decision making, or at least 25 minutes of qualifying total time on the […]