New Patient Visit

The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making and/or the provider spends 15–29 minutes of total time on the encounter on a single date. CPT Code: 99202  

New Patient Visit, Low Complexity

The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making and/or the provider spends 30–44 minutes of total time on the encounter on a single date. CPT Code: 99203  

New Patient Visit, Moderate Complexity

The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making and/or the provider spends 45–59 minutes of total time on the encounter on a single date. CPT Code: 99204  

Established Patient Visit

The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making and/or the provider spends 10–19 minutes of total time on the encounter on a single date. CPT Code: 99212  

Consultation

The provider performs a consultation at the request of another provider. When selecting an E/M service level for an inpatient consultation, there are three key components that must be met in order to report the code appropriately. These components are in addition to the medical necessity for performing the procedure(s). CPT Code: 99251