CPT code 99367 – Medical team conference without patient

Key takeaways

CPT code 99367 reports a physician’s participation in a medical team conference of 30 minutes or more, held without the patient or family.

Nonphysician qualified health care professionals report the same conference with 99368, and with 99366 when the patient or family attends.

A physician at a conference with the patient or family present reports an E/M code, not 99366.

Documentation must show the date, start and stop times, every participant’s credentials, the conditions discussed, and the care plan decisions.

Medicare never pays 99367 separately because CMS gives it status indicator B, so payment depends on Medicaid and commercial payer policy.

CPT code 99367: Official descriptor and code family overview

CPT code 99367 reports a physician’s participation in a medical team conference of 30 minutes or more, held without the patient or family. The American Medical Association’s Current Procedural Terminology gives its official descriptor as:

Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician.

The code sits in the case management services range, 99366-99368, which captures care planning done in team conferences rather than in a face-to-face visit.

The three codes share one service definition. They differ on two points: whether the patient or family is present, and whether the participant is a physician. The rest of the evaluation and management range sits in our procedure codes library.

99367 is the physician code for a conference without the patient. A social worker or therapist at the same meeting reports 99368, or 99366 if the patient or family joins. Sending 99367 under a nonphysician’s NPI is a provider-type mismatch and a predictable denial.

Who can bill CPT 99367? Eligible provider types

Only physicians can bill CPT code 99367. The descriptor ends with “participation by physician”, so the code belongs to MDs and DOs of any specialty who take part in the conference.

Typical billers, consistent with AAPC coding guidance, include:

• Attending physicians and hospitalists running discharge or care planning conferences
• Psychiatrists in interdisciplinary behavioral health case reviews
• Physiatrists leading rehabilitation team meetings
• Oncologists and palliative care physicians at tumor boards or goals-of-care planning meetings
• Developmental and complex care pediatricians coordinating multidisciplinary plans

Who cannot bill 99367: Licensed clinical social workers, occupational therapists, speech-language pathologists, registered nurses, physical therapists, psychologists, and dietitians. They report the same conference without the patient with 99368. Nurse practitioners and physician assistants fall under the nonphysician wording of 99368 unless a payer’s policy says otherwise.

CPT adds participation rules that apply to every code in the family:

• The conference involves at least three qualified health care professionals from different specialties or disciplines, each providing direct care to the patient.
• Each reporting participant has evaluated or treated the patient face to face within the previous 60 days, separate from the conference.
• Only one individual from the same specialty may report a code for the same conference.
• Participation that a facility or organization is contractually obligated to provide is not reported separately.

Practices treating complex mental health and rehabilitation patients often hold these conferences for shared patients. Each eligible participant bills under their own NPI for their own time, rather than splitting one claim across the team.

What does CPT 99367 cover? Service definition and time requirements

CPT code 99367 covers an interdisciplinary team conference focused on one patient’s care plan, held without the patient or family. The conference addresses medical, functional, psychosocial, or care coordination needs. The physician must contribute to the discussion, and attendance alone does not qualify.

Time requirements: How long must the conference be?

The physician must take part in at least 30 minutes of the conference. Reported time starts when the team begins reviewing the patient and ends when that review concludes. Record keeping and report writing do not count toward the 30 minutes.

• What counts: Discussion of the patient’s conditions, care plan decisions, and interdisciplinary communication during the meeting.
• What does not count: Chart review before the conference, writing notes after it, and travel between locations.
• How to document it: Record the start and end time of the patient’s review. If the physician joined late or left early, document their own participation window.

Team conference services under 30 minutes are not reported separately. If the review of the patient runs 28 minutes, 99367 cannot be billed, and no shorter code exists in this family.

Documentation requirements for CPT 99367

Documentation for CPT code 99367 must be thorough enough to withstand a payer audit. Missing participant credentials and absent start and stop times are the weak points auditors look for first. Consistent medical billing compliance practices reduce that exposure.

The medical record must capture all of the following elements:

• Date of the conference, matching the date of service on the claim.
• Start time and end time of the patient’s review, not just total minutes.
• Patient name and the diagnosis codes under discussion.
• Names and credentials of all participants, with the professional designation for every attendee.
• A summary of the discussion, covering conditions reviewed, decisions made, and care plan changes agreed.
• The physician’s own contribution, including the information they gave and their treatment recommendations.
• Confirmation that the patient and family were not present, since presence changes the code.
• Conference format, in person or by teleconference, as some payers add requirements for remote meetings.

Payers flag records that list total time without start and stop times, omit credentials, or describe the conference in boilerplate. Give each element above its own field in the conference note, rather than burying it in a narrative paragraph.

CPT 99367 vs 99366 vs 99368: Choosing the right code

The 99366-99368 family covers one service, and the right code depends on two facts. Was the patient or family present? And is the participant a physician? Getting either one wrong is a leading cause of denials for these codes.

When several providers attend the same conference, each reports the code that fits their own provider type and participation time. A physician and a social worker at a 35-minute conference without the patient bill 99367 and 99368, under separate NPIs. Neither bills for the other’s time.

The chart below adds the two checks every participant must clear before any of these codes applies.

Medicare coverage: Does Medicare pay for CPT 99367?

No. Medicare never pays CPT code 99367 as a separate service. CMS assigns 99366, 99367, and 99368 status indicator B on the Medicare Physician Fee Schedule, meaning payment is always bundled into another service.

Key points for Medicare and other payers:

• Status B applies nationally, so no MAC, LCD, or locality makes 99367 separately payable.
• The fee schedule carries no payable RVUs or fee amount for 99367, so a Medicare claim line for it pays $0.
• Medicare Advantage plans often follow the fee schedule’s status indicators, but check each plan’s reimbursement policy.
• Medicaid coverage varies by state and managed care plan, and some state programs pay team conference codes.
• Commercial payers set their own policy, so confirm coverage in the payer contract before the conference.

For Medicare patients, physicians can sometimes capture care coordination time through other codes, such as chronic care management under 99490 or 99491. Those codes have their own consent, time, and documentation requirements, so check them before switching.

Reimbursement for CPT 99367 by payer

Reimbursement for CPT code 99367 depends entirely on the payer, because Medicare never pays it separately. The CMS Physician Fee Schedule lookup tool shows the code’s status indicator for the current year.

Recheck these policies at the start of each calendar year. A payer that changes its reimbursement policy can start or stop paying 99367 without much notice.

NCCI edits and same-day billing restrictions for CPT 99367

The CMS National Correct Coding Initiative (NCCI) sets bundling rules for 99367. Chapter 11 of the NCCI Policy Manual covers codes in the 90000-99999 range. It lists which codes cannot be billed together on the same date without a modifier showing a separate, distinct service.

Core restrictions affecting 99367 claims:

• Same-day E/M codes: Billing 99367 with an E/M service by the same physician on the same date can trigger a bundling edit. Modifier 25 does not resolve this automatically, so the services must be clearly distinct.
• One code per conference: A physician reports 99367 only when the patient and family are absent. If they attend, the physician reports an E/M code instead, never 99366.
• Several patients on one day: Billing 99367 for different patients on the same date is permissible. Each claim needs separate documentation of the conference time for that patient.

Claims management software can flag likely NCCI conflicts before submission, which cuts manual rework. Check the current quarterly tables, because NCCI edit pairs update four times a year.

How to bill CPT 99367: Step-by-step claim submission

Submitting 99367 claims correctly means checking payer policy, documenting the conference, selecting the right code, and routing the claim correctly. Pabau, the practice software we build, submits US claims electronically through the Claim.MD clearinghouse. It checks the patient’s eligibility in real time before the claim reaches the payer.

1. Check payer policy first. Medicare never pays 99367 separately, so confirm Medicaid or commercial coverage before the conference.
2. Conduct and document the conference. Confirm at least three disciplines took part, then record start and end times, credentials, conditions discussed, and care plan decisions.
3. Select the correct code. Confirm the billing provider is a physician and the patient and family were absent. A nonphysician uses 99368, and a physician with the patient present uses an E/M code.
4. Assign the place-of-service (POS) code. Use the POS for where the physician performs the service. Examples are 21 for inpatient hospital, 11 for office, and 31 for a skilled nursing facility.
5. Link an ICD-10 diagnosis code. Choose the primary condition that made the coordinated care conference necessary (see the ICD-10 section below).
6. Submit and monitor. Track the remittance advice and compare any denial with the patterns in the next section. A clean claim submission process catches most of these before they reach the payer.

Common billing errors and denial reasons for CPT 99367

Most 99367 denials trace back to a short list of errors. Effective denial management workflows start by knowing which ones generate the most volume.

ICD-10 diagnosis codes to use with CPT 99367

CPT code 99367 must be submitted with an ICD-10-CM diagnosis code for the condition that requires coordinated interdisciplinary care. That code justifies the medical necessity of the conference.

A vague or nonspecific code can trigger a denial even when the conference was clinically appropriate. Build your medical billing workflow so the diagnosis comes from the current record, not a prior visit.

Common ICD-10 pairings for 99367 include conditions that routinely need interdisciplinary care:

• Chronic disease management: Type 2 diabetes with complications (E11.xx), chronic kidney disease (N18.x), heart failure (I50.xx)
• Neurological and rehabilitation: Stroke sequelae (I69.x), cerebral palsy (G80.x), traumatic brain injury (S06.x)
• Mental and behavioral health: Major depressive disorder (F33.x), schizophrenia (F20.x), autism spectrum disorder (F84.0)
• Pediatric complex care: Down syndrome (Q90.x), failure to thrive (R62.51), developmental disorders requiring multidisciplinary input
• Palliative and end-of-life care: Malignant neoplasm codes (C00-C96) for the active cancer, palliative care encounter (Z51.5)

The diagnosis on the 99367 claim should reflect the primary condition discussed in the conference, not necessarily the patient’s longest-standing diagnosis. Some commercial and Medicaid payers publish approved diagnosis lists for team conference codes, so check them.

How Pabau supports team conference billing

Team conference notes often live in shared documents or meeting minutes, away from the patient record. Coders then chase start times, attendee names, and credentials before they can pick between 99367 and 99368.

In Pabau, the conference note can be a custom digital form attached to the patient’s record. Fields for start and end time, attendees and credentials, patient presence, and care plan decisions are completed during the meeting. Claims then go out through the Claim.MD integration, after a real-time eligibility check.

The result is a note that supports the claim on its own. Your team can see which code applies and which payer will pay it before the claim leaves the practice.

Reduce denials on team conference codes

Pabau keeps conference notes, attendee credentials, and claim submission in one platform. Each 99367 claim is then backed by a complete record before it reaches the payer.

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Conclusion

CPT code 99367 belongs to physicians, and only for conferences the patient and family do not attend. Treat provider type and patient presence as the first two checks on every team conference claim.

Medicare will not pay the code separately, so your revenue from it depends on Medicaid and commercial policy. Build those rules into your note templates and payer setup once, and the code stops generating avoidable denials.

Book a demo to see how Pabau handles care coordination documentation and billing for multidisciplinary practices.

Continue your research

Want to understand how claims reach payers? Medical claims clearinghouse guide explains the electronic pathway from claim submission to remittance advice.

Need to reduce claim rejections systematically? Revenue cycle management overview covers the end-to-end workflow from eligibility through payment posting.

Dealing with denied claims? Denial codes in medical billing breaks down CARC and RARC codes used in ERA responses.

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