CPT® Code 99392: Periodic Comprehensive Preventive Visit, Established Patient (Age 1–4 Years)

CPT® Code 99392: Periodic Comprehensive Preventive Visit, Established Patient (Age 1–4 Years)

CPT® code 99392 is used to report a periodic comprehensive preventive medicine reevaluation and management (E/M) service for an established patient aged 1 to 4 years. This code represents a routine well-child visit focused on health maintenance, developmental surveillance, and anticipatory guidance tailored to early childhood.

What is CPT 99392?

CPT 99392 applies to periodic wellness visits for toddlers and preschool-aged children who have been previously seen by the provider or practice. These visits emphasize:

• Comprehensive medical, family, and social history review
• Age-appropriate physical examination including growth, development, and behavioral assessments
• Screening for vision, hearing, anemia, lead exposure, and other common pediatric concerns
• Immunization review and administration as needed
• Anticipatory guidance on nutrition, safety, sleep, language development, and social interaction

The purpose is to monitor normal growth, detect potential problems early, and support parents in promoting healthy development.

When to report CPT code 99392

You may report 99392 when:

• The patient is between 1 and 4 years old
• The visit is for preventive care, not treatment of illness or injury
• The patient is established in your practice (seen within the past three years)
• The encounter includes a comprehensive history, exam, and counseling focused on wellness

Billing tips and best practices

• CPT 99392 should be reported once per year for preventive visits within this age range, following payer-specific frequency guidelines.
• If a separately identifiable problem is addressed, report the appropriate E/M code with modifier -25 in addition to 99392.
• Document all screenings and anticipatory guidance performed to support preventive intent.
• Many payers require the use of specific preventive service codes and may have different rules for vaccines and screenings.

Simplify Pediatric Preventive Care with OptiMantra

OptiMantra helps pediatric and family practices efficiently manage and document comprehensive well-child visits like CPT 99392. The platform offers:

• Age-specific templates for early childhood preventive visits
• Integrated tracking of immunizations and developmental screenings
• Automated reminders for upcoming wellness visits and vaccine schedules
• Patient portals that support parental engagement and pre-visit questionnaires

With OptiMantra, providers can streamline documentation, improve preventive care compliance, and focus on nurturing healthy children—while optimizing administrative workflows.

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