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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Related Studies

Ontology: New Patient Office or Other Outpatient Services (C0695210)

Concepts Health Care Activity (T058)
CPT 1013627
English New Patient Office or Other Outpatient Services
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Provider Billing

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