E/M New Outpatient Visit

Aka: E/M New Outpatient Visit, E/M New Office Visit, CPT 99201, CPT 99202, CPT 99203, CPT 99204, CPT 99205

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II. Indication

  1. E/M New Patient

III. New Outpatient: CPT Code 99201

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Problem Focused History
    2. E/M Problem Focused Exam
    3. E/M Straightforward Medical Decision
  2. E/M Self Limited or Minor Problem
  3. Physician Time: 10 minutes

IV. New Outpatient: CPT Code 99202

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Expanded Problem Focused History
    2. E/M Expanded Problem Focused Exam
    3. E/M Straightforward Medical Decision
  2. Problem severity
    1. E/M Low Severity Problem
    2. E/M Moderate Severity Problem
  3. Physician Time: 20 minutes

V. New Outpatient: CPT Code 99203

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Detailed History
    2. E/M Detailed Exam
    3. E/M Low Complexity Medical Decision
  2. E/M Moderate Severity Problem
  3. Physician Time: 30 minutes

VI. New Outpatient: CPT Code 99204

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Comprehensive History
    2. E/M Comprehensive Exam
    3. E/M Moderate Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 45 minutes

VII. New Outpatient: CPT Code 99205

  1. Key Components (All 3 meet or exceed requirements)
    1. E/M Comprehensive History
    2. E/M Comprehensive Exam
    3. E/M High Complexity Medical Decision
  2. Problem Severity
    1. E/M Moderate Severity Problem
    2. E/M High Severity Problem
  3. Physician Time: 60 minutes

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