New LFP Code for Additional Patients Seen During Home Visits
Effective September 1, 2026, a new interaction codes will be added to the LFP Payment Schedule to support billing when more than one patient is seen at the same home location on the same date.
The changes add a new $50 interaction code for additional patients and clarify when to use the existing $100 home visit code. The new code applies when physicians provide care to multiple patients during a single attendance at a private residence or in common areas of multi-unit residential settings.
98038/98068 – LFP In-Person Visit in the Patient’s Home – Additional Patient(s) — $50
LFP: 98038 ………….. Locum LFP: 98068
Notes:
(a) Payable for an in-person visit with direct patient interaction provided by a physician to a patient in their Home Setting, as deemed appropriate by the physician, when more than one patient is seen by the same physician at the same location on the same date.
(b) Payable for each additional patient seen in:
- The same private residence (i.e., the same Dwelling Unit).
- A common area within a building or building complex that contains multiple Dwelling Units.
(c) When the physician is clinically required to return to the Home Setting to see an additional patient on the same date, the home visit may be billed under 98033/98063. A claim note record must be provided indicating the time of each visit and the reason why the additional visit was required.
(d) Not payable for:
- Review of a patient’s chart without direct patient interaction.
- On-site interaction with the care team without direct patient interaction.
98033/98063 – LFP In-Person Visit in the Patient’s Home — $100
LFP: 98033 ………….. Locum LFP: 98063
Notes:
(a) Payable for an in-person visit with direct patient interaction provided by a physician to a patient in their Home Setting, as deemed appropriate by the physician.
(b) Additional patients seen in one of the following locations must be billed using 98038/98068:
- The same private residence (i.e., the same Dwelling Unit).
- A common area within a building or building complex that contains multiple Dwelling Units.
(c) Not payable for:
- Review of a patient’s chart without direct patient interaction.
- On-site interaction with the care team without direct patient interaction.
The updated definitions also provide greater clarity around the following terms:
Home Setting: A private residence, assisted living residence, or other setting where a person lives, but not a Facility.
Dwelling Unit: A self-contained living suite used as a residence by one or more persons, generally containing cooking, eating, living, sleeping, and sanitary facilities.
How the New Code Applies: Examples
1. Two patients seen in the same assisted living unit
A physician sees two patients in Unit 101 of an assisted living residence.
The second patient is considered an additional patient because both patients were seen in the same Dwelling Unit.
3. Patients seen in different units
A physician sees one patient in Unit 101 and another in Unit 205 of an assisted living residence or condo building.
Because each patient is seen in a different Dwelling Unit, each visit may be billed as a home visit rather than using the additional patient code.
4. Multiple patients seen in a common area
A physician sees two or more patients in a common area of an assisted living residence, condo building, or other building complex containing multiple Dwelling Units, such as a multipurpose room or clubhouse.
The new additional patient code applies to each additional patient seen in the common area on the same date.