CPT® code 99387 is used to report an initial comprehensive preventive medicine evaluation and management (E/M) service for a new patient aged 65 years or older. This code reflects a preventive wellness visit, not driven by a specific complaint or problem, and includes a full history, physical examination, and appropriate counseling or guidance based on the patient’s age and risk factors.
What is CPT 99387?
CPT 99387 represents a preventive, age-specific visit for older adults who are new to the provider or practice. Unlike problem-focused E/M visits, this code applies to asymptomatic patients and is designed to support early detection, health maintenance, and patient education.
This service typically includes:
- A comprehensive review of medical, family, and social history
- A complete physical exam tailored to age-related needs
- Screening for cognitive function, fall risk, and sensory impairment
- Review of lifestyle factors, such as diet, mobility, social support, and medication use
- Discussion of age-appropriate screenings (e.g., colonoscopy, mammogram, DEXA)
- Administration or review of immunizations
CPT 99387 does not cover evaluation of new symptoms or management of chronic conditions. If a separately identifiable problem is addressed during the same visit, an additional E/M code may be reported with modifier -25.
When to report CPT code 99387
You may report 99387 when:
- The patient is 65 years or older
- The visit is a first-time preventive evaluation with your practice
- The service includes a comprehensive history, physical exam, and anticipatory guidance
- No primary medical complaints are evaluated or treated during the encounter
Billing considerations
- CPT 99387 is used for new patients only and is typically covered once every 12 months by most commercial payers.
- Medicare does not reimburse CPT 99387. Instead, use G0438 (Initial Annual Wellness Visit) for Medicare beneficiaries.
- Preventive services may not require a copay or deductible depending on the patient’s insurance plan and ACA provisions.
- Document clearly to support preventive intent, including any screening tools or health risk assessments used.
Make Preventive Care for Seniors Easy with OptiMantra
OptiMantra supports practices offering preventive services like CPT 99387 with customizable templates and integrated billing workflows designed to simplify documentation and reduce administrative overhead.
With OptiMantra, providers can:
- Create and use custom charting templates tailored to preventive visits for older adults
- Document screenings, immunizations, and counseling in structured note fields
- Track medications and other key health data within the patient record
- Generate accurate superbills with linked CPT and ICD codes
- Submit claims electronically and monitor billing status in one place
OptiMantra’s flexible EMR tools help providers deliver thorough, well-documented care that supports preventive goals for aging populations.
Try OptiMantra for free here!
