Guide

99446–99449: interprofessional consults, documented and billed

Summary

A true curbside — an informal hallway question to a colleague — is generally not separately billable, because no structured request, documentation, or report exists. The billable pathway is the interprofessional consultation family (99446–99449, plus 99451 and the requesting-side 99452), which pays a consultant for a documented telephone, internet, or EHR-based assessment made at the treating clinician's written request. Short of that, the conversation can still raise your own visit's medical-decision-making level.

By Gale Editorial · Updated 2026-07-27. Every figure cited to a dated source. How we write.

Is a curbside consult billable?

A curbside consult — an informal, unstructured request for a colleague's opinion, the kind traded in a hallway or a quick message — is generally not a separately reportable service. The codes that pay for peer-to-peer input require a documented request, a defined amount of consultant time, and a written report back to the treating clinician. When those elements are absent, no consultation code applies, and the correct move is to credit the discussion inside the visit you are already billing.

That is not a loophole closing — it is the design. A curbside is fast precisely because it skips the request, the record, and the report. The moment you add those three things, you are no longer doing a curbside; you are doing an interprofessional consultation, and a different set of codes opens up.

The interprofessional consultation codes

The interprofessional consultation family splits into two roles. The consultant — the clinician giving the opinion — reports an interprofessional consultation from the 99446 through 99449 range when the service includes both a verbal and a written report, or 99451 when only a written report is rendered through the record. The treating clinician who asked for the opinion reports 99452 for the request and referral work. Each code is conditioned on consultant time and a documented request, so the paperwork is the service.

Code	Reported by	What it covers
99446–99449	Consultant	Telephone, internet, or EHR assessment with a verbal and written report, tiered by cumulative consultant time
99451	Consultant	Written report only, time-conditioned
99452	Treating clinician	The request and referral work, time-conditioned

The minute thresholds live in the code descriptors — read them rather than estimating, because the tier you report has to match the time you documented. Medicare also recognizes only certain behavioral-health provider types and applies incident-to limits, so confirm that both the requesting and the consulting clinician are eligible to report their side 1Ref 1Centers for Medicare & Medicaid Services (2025).Medicare and Mental Health Coverage.Medicare's recognition of specific behavioral-health provider types and its incident-to constraints, used to confirm which clinicians may report each side of an interprofessional consult..

Is the code payable when you deliver it electronically?

Whether the consult is reimbursed depends on the payer, and for Medicare on the published telehealth list. CMS releases the definitive list of codes payable as Medicare telehealth each year and marks which are permanent and which are audio-only eligible 2Ref 2Centers for Medicare & Medicaid Services (2026).List of Telehealth Services.That CMS publishes the annual list of codes payable as Medicare telehealth, used to check whether an electronically delivered consult code is payable and audio-only eligible.. Before you bill an interprofessional consult delivered electronically, confirm the specific code appears on the current-year list and that your payer recognizes the interprofessional family at all — commercial coverage of these codes is uneven, and a code that pays under one contract may be bundled or denied under another.

If the code is not covered, do not resubmit it under a face-to-face visit code for a service that never had a face-to-face component. The cleaner path when coverage is absent is the one two sections down: let the documented discussion raise the level of a visit you legitimately performed.

The documentation that makes it a service

Three elements convert a conversation into a reportable consult. A request from the treating clinician, documented in the chart with the reason for it; the consultant's assessment and the time spent; and a written report returned to the requester. Telehealth billing then carries its own place-of-service and modifier conventions, which HHS's billing guidance lays out for electronically delivered services 3Ref 3U.S. Department of Health and Human Services (2026).Billing for telehealth.HHS's telehealth billing guidance on the place-of-service and modifier conventions for electronically delivered services.. Miss the request note or the written report and the service is unbillable, however substantive the discussion was.

For a solo practice with no billing department, the failure mode is predictable: the clinical work happens, the documentation does not, and the claim either never goes out or comes back denied. Build the request-and-report step into the encounter template so it is captured while the consult is fresh, the same way you would handle the dropped call in a telehealth session — protocol beats memory.

Credit the discussion inside your own visit

When a formal consult is not warranted or not covered, the conversation still counts — inside your own note. Under the 2021 office-visit framework, evaluation-and-management levels are selected by medical decision making or total time rather than history and exam 4Ref 4Centers for Medicare & Medicaid Services (2023).Evaluation and Management Services Guide.That 2021+ office-visit E/M levels are selected by medical decision making or total time, and what the MDM data element requires.. The data element of medical decision making credits discussion of management or test interpretation with an external physician or other qualified health professional 5Ref 5American Medical Association (2023).CPT evaluation and management (E/M) revisions.That the AMA's E/M revisions base office-visit levels on MDM or time, and that the MDM data category credits discussion of management with an external physician or qualified professional.. A documented peer discussion can therefore raise the complexity, and the supported level, of the visit you are already billing.

This is the answer most solo billers are actually looking for. You do not need the interprofessional codes to be paid for the thinking a curbside represents — you need to document that the discussion happened, with whom, and how it changed your plan, then select the visit level the resulting complexity supports. The same instinct rewards other time-based Medicare conversations, like 99497: paying for the goals-of-care conversation.

When the formality earns its keep

Decide when the documentation overhead pays for itself. For an occasional curbside, crediting the discussion in your own visit is simpler and often pays as well. The interprofessional codes earn their overhead when you are the consultant others lean on repeatedly, or when the requesting side is a distinct clinician — a clinician #2 in a scaling-group arrangement — whose request-and-report loop you want captured as its own reimbursable event rather than folded into someone else's visit level.

Track it like any other line of service. If interprofessional consults become a meaningful share of your week, they belong in your practice-metrics review the same as visits and no-shows, because unbilled consulting time is the quietest way a solo practice gives away margin.

Common questions

Generally no. A hallway question lacks the three things the interprofessional codes require: a documented request from the treating clinician, recorded consultant time, and a written report back. Without them, no consultation code applies. What you can do is document the discussion in your own visit note, where it may raise the medical-decision-making complexity and the level you report for that encounter.

They are the two sides of the same consult. The treating clinician who requests the opinion reports 99452 for the request and referral work. The consultant who renders the opinion reports a code from the 99446 to 99449 range when the service includes a verbal and written report, or 99451 when only a written report is returned through the record.

Often yes. These are billable services subject to the patient's benefit design, so cost-sharing can apply, including amounts that count toward a deductible. Document the patient's agreement to the consult before billing it, and put any resulting balance on the statement plainly rather than letting it surface later as a charge for a service the patient did not know occurred.

Commercial coverage of the interprofessional family is uneven, so confirm the code on the payer's policy before you rely on it, and for Medicare check the current telehealth list. When the codes are not covered, do not force the service into a face-to-face visit code. Instead, credit the documented discussion inside a visit you actually performed and select the level its complexity supports.

The interprofessional codes assume the consultant has not provided a recent face-to-face service to the patient and that the consult does not promptly become a transfer of care. If either is true, a different code fits the encounter. Check the code descriptor's recent-contact window before reporting, because billing a consult when a direct visit code applies is a common and avoidable error.

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References

1.Centers for Medicare & Medicaid Services (2025). Medicare and Mental Health Coverage. CMS Medicare Learning Network (MLN1986542). link ✓Medicare's recognition of specific behavioral-health provider types and its incident-to constraints, used to confirm which clinicians may report each side of an interprofessional consult.
2.Centers for Medicare & Medicaid Services (2026). List of Telehealth Services. Centers for Medicare & Medicaid Services (CMS). link ✓That CMS publishes the annual list of codes payable as Medicare telehealth, used to check whether an electronically delivered consult code is payable and audio-only eligible.
3.U.S. Department of Health and Human Services (2026). Billing for telehealth. Telehealth.HHS.gov. linkHHS's telehealth billing guidance on the place-of-service and modifier conventions for electronically delivered services.
4.Centers for Medicare & Medicaid Services (2023). Evaluation and Management Services Guide. CMS Medicare Learning Network (MLN006764). link ✓That 2021+ office-visit E/M levels are selected by medical decision making or total time, and what the MDM data element requires.
5.American Medical Association (2023). CPT evaluation and management (E/M) revisions. American Medical Association (AMA). link ✓That the AMA's E/M revisions base office-visit levels on MDM or time, and that the MDM data category credits discussion of management with an external physician or qualified professional.

https://www.gale.care/for-providers/th-interprofessional-consults · 5 sources. Competitor details are cited to dated public sources and maintained as they change; figures are estimates, not commitments. Synthetic demonstration.

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