15 Most Commonly Used Family Practice CPT Codes
Family Practice CPT Codes are standardized procedure codes used to report services provided in family medicine clinics, including office visits, preventive exams, lab tests, and procedures. These codes help document patient care, support insurance claims, and maintain proper billing workflows.
Using the correct CPT codes helps prevent claim denials, improves documentation, and supports timely reimbursements. This guide explains the 15 most commonly used CPT codes used in family practice and how they are used in daily family medicine practice.
Table of Contents
1. CPT Code 99213 – Established Patient Office Visit (Moderate Complexity)
Physicians report 99213 when treating established patients with stable chronic conditions such as controlled diabetes, hypertension, asthma, or thyroid disorders. The total provider time must be 20–29 minutes on the encounter date, including reviewing records and documenting care. Documentation must show one stable chronic illness or one acute uncomplicated illness.
2. CPT Code 99203 – New Patient Office Visit
New patient visits requiring moderate medical decision-making are reported under 99203. Providers must review the patient’s medical history, perform examination, and establish a treatment plan. Total time must be 30–44 minutes. This code is commonly used when patients establish care or seek evaluation for new symptoms like fatigue, chronic cough, or uncontrolled blood pressure.
3. CPT Code 99395 – Preventive Visit (Established Patient, Age 18–39)
Annual preventive exams for adults aged 18–39 are reported using 99395. This visit includes full physical examination, preventive screening recommendations, and risk assessment. Providers may evaluate BMI, blood pressure, and lifestyle risk factors. Most insurance plans cover this visit once every 365 days, and it must not include treatment of existing conditions unless separately documented.
Preventive Visit Coverage and Billing Comparison
4. CPT Code 90471 – Immunization Administration
Vaccine administration is reported using 90471 when physicians administer vaccines such as influenza, hepatitis B, tetanus, or COVID-19 vaccines. Proper documentation must include vaccine name, lot number, manufacturer, dosage, and administration site. This code reports the administration service, while the vaccine itself is billed separately using its own CPT code.
5. CPT Code 90686 – Influenza Vaccine Product
Influenza vaccination using preservative-free vaccine is reported under CPT 90686. This code represents the vaccine product itself, not the administration. Clinics report higher volumes of this code between September and March, aligning with CDC seasonal vaccination recommendations.
Vaccine Billing and Coding Reference Table:
6. CPT Code 36415 – Venipuncture for Blood Collection
Blood specimen collection through venipuncture is reported using CPT 36415. This procedure supports diagnostic tests such as CBC, lipid panel, thyroid panel, and metabolic panel. It is performed using a needle inserted into a vein, typically in the arm, and is required before laboratory analysis. CPT 36415 is commonly used in Family practice lab and procedure billing to report blood collection performed during outpatient visits.
7. CPT Code 80053 – Comprehensive Metabolic Panel (CMP)
Comprehensive metabolic panel testing includes evaluation of 14 different laboratory markers, including glucose, sodium, potassium, creatinine, liver enzymes, and kidney function markers. Physicians order CMP to monitor diabetes, kidney disease, liver disease, and electrolyte imbalances. Results typically become available within 24 hours.
8. CPT Code 85025 – Complete Blood Count (CBC) with Differential
CBC testing evaluates red blood cells, white blood cells, hemoglobin, hematocrit, and platelet levels. Physicians use this test to detect infections, anemia, inflammation, and immune disorders. It is commonly ordered during annual exams or when patients present with fatigue or infection symptoms.
9. CPT Code 82947 – Blood Glucose Test
Blood glucose testing measures sugar levels in the blood. Physicians use this test to diagnose diabetes or monitor existing diabetic patients. Normal fasting glucose levels range between 70 and 99 mg/dL, while higher values may indicate prediabetes or diabetes.
10. CPT Code 81002 – Urinalysis without Microscopy
Urinalysis testing evaluates urine for infection, kidney disease, dehydration, or metabolic abnormalities. Providers perform this test in-office using dipstick testing, and results are available within minutes. It helps diagnose urinary tract infections and kidney disorders.
11. CPT Code 87880 – Rapid Strep Test
Rapid antigen detection testing identifies streptococcal bacterial infection in patients presenting with sore throat, fever, and swollen lymph nodes. The test provides results within 5 to 10 minutes, allowing physicians to begin antibiotic treatment promptly when clinically indicated. Among commonly performed diagnostic services, this procedure remains one of the frequently reported Family Practice CPT Codes in outpatient family medicine clinics.
Want to know how reimbursement updates impact primary care diagnostic services like rapid strep testing? Check out here:
12. CPT Code 93000 – Electrocardiogram (ECG) with Interpretation
ECG testing records electrical activity of the heart. Physicians use this test to detect arrhythmias, heart attack risk, and cardiac abnormalities. The procedure takes approximately 5–10 minutes, and interpretation must be documented by the provider.
13. CPT Code 17000 – Destruction of Premalignant Skin Lesion
Physicians report this code when removing premalignant lesions such as actinic keratosis using cryotherapy or electrosurgery. This procedure helps prevent progression to skin cancer and is commonly performed in outpatient clinics. CPT 17000 is reported in Family Practice Medical Billing and Coding to document lesion removal procedures performed during office visits.
14. CPT Code 99401 – Preventive Counseling Visit
Preventive counseling services lasting approximately 15 minutes are reported under CPT 99401. Providers use this code when counseling patients on smoking cessation, diet, exercise, or disease prevention. This visit focuses on prevention rather than diagnosis or treatment.
15. CPT Code 80061 – Lipid Panel Test
Lipid panel testing measures cholesterol levels including HDL, LDL, and triglycerides. Physicians use this test to assess cardiovascular risk and monitor treatment effectiveness. Normal total cholesterol levels should remain below 200 mg/dL.
Tips for Using Family Practice CPT Codes Correctly
Proper use of Family Practice CPT Codes helps prevent claim rejection and supports smooth billing workflows. Following the right coding tips helps maintain proper documentation, supports faster claim processing, and reduces billing errors. Many clinics Outsource Family Practice Billing to trained billing professionals who manage CPT code selection, claim submission, and payer compliance. These tips help maintain consistent billing standards and improve overall revenue cycle performance.
Key Coding Tips to Prevent Claim Denials
Verify patient insurance eligibility before assigning CPT codes
Select CPT codes based on the exact service performed
Link CPT codes with correct ICD-10 diagnosis codes
Avoid billing bundled services separately
Use modifiers like Modifier-25 when reporting multiple services
Follow Medicare and payer-specific billing guidelines
Maintain complete clinical documentation for each service
Submit claims within payer deadlines to prevent rejection
Proper coding workflows help improve billing efficiency and support Family Practice Billing for Faster Reimbursements while maintaining organized claim submission.
Conclusion:
Using the correct CPT codes helps maintain proper documentation, reduces claim denials, and supports timely reimbursements in family medicine clinics. The 15 most commonly used CPT codes used in family practice help providers accurately report office visits, preventive care, lab testing, and procedures performed during daily patient encounters.
Managing coding requirements and payer guidelines can be challenging without proper billing support. Reliable Family Practice Billing Services help improve coding accuracy, reduce administrative burden, and maintain smooth billing workflows. Contact MBW RCM today to learn how our billing solutions can help your practice achieve more efficient and consistent billing performance.
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