CPT 99367 covers medical team conferences involving an interdisciplinary team, without the patient or family present, lasting 30 minutes or more and involving physician participation. This code is especially relevant in pediatric settings where complex care planning is needed. In this article, we’ll explore best practices for documentation of functional goals in child development, proper time tracking, and how to combine this service with vaccine billing.

Understanding CPT 99367

• Definition & Use
  CPT 99367 applies when a physician attends a non–face-to‑face medical team conference of 30 minutes or more, aiming to discuss and coordinate care for a pediatric patient.
  
  
• Payer Limitations
  CMS (Medicare) bundles CPT 99367 into other services—this means it is typically not separately reimbursed under Medicare’s National Physician Fee Schedule (Status Indicator “B”).
  
  
• Frequency Restrictions & Authorization
  Some Medicaid plans (e.g., Texas Medicaid) allow reimbursement for one such conference every six months, with medical necessity documentation. Prior authorization may also be required.
  
  
• Concurrent Critical Care
  AMA CPT® guidelines affirm that it's allowable to report both 99367 and 99291 on the same day (e.g., a critical care episode plus a meeting to discuss that care).
  
  

Documenting Functional Goals in Pediatrics

In pediatric care, ensure thorough documentation of functional goals when using 99367:

• Detail developmental milestones targeted (e.g., gross motor, fine motor, communication, behavior).
  
  
• Specify short- and long-term objectives: e.g., “Increase crawling distance,” “Improve play interaction,” “Enhance self-feeding skills.”
  
  
• Clarify roles of team members (e.g., speech therapist, occupational therapist, behavioral specialist) and how each contributes to the goal plan.
  
  
• Show that the conference is integral for coordinating interdisciplinary efforts to achieve these goals.
  
  

Time Tracking Best Practices

Accurate time documentation is critical for billing CPT 99367:

• Record the date, start time, and end time of the conference.
  
  
• Ensure physician participation constitutes at least 30 minutes of discussion.
  
  
• Log the purpose of the meeting, attendees, and outcomes directly in the patient record.
  
  
• Avoid including non–face-to‑face tasks that are administrative (e.g., filing charts, scheduling).
  
  

Combining with Vaccine Codes

Although CPT 99367 is unrelated to vaccine administration, in pediatric visits that include immunization, you may need to bill separate service lines:

• Use 90460 for vaccine administration with counseling by physician or qualified healthcare professional for patients ≤ 18 years.
  
  
• For additional components in the same visit, use +90461.
  
  
• Always separately report the vaccine product codes (e.g., 90670 – pneumococcal, 90707 – MMR).
  
  
• Common practice: code well-child visit (e.g., 99391–99395), then attach modifier 25 for any problem-oriented E/M on the same day; add vaccine product codes and administration codes accordingly.

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Summary Table: Workflow & Key Tips

‍Takeaways

CPT 99367 supports pediatric case management through non–face-to‑face collaborative planning. To bill correctly:

• Confirm 30+ minutes with physician presence and document meticulously.
  
  
• Follow payer-specific rules—Medicare may not reimburse, some Medicaid plans limit frequency or need prior authorization.
  
  
• Integrate development goals tightly into documentation for pediatric-specific care plans.
  
  
• When vaccines are also administered, ensure those services are billed separately with correct administration and product coding.

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