2021 E/M Visit CPT codes (New versus Established Patient)

New Patient
(99201 has been deleted. To report, use 99202)

99202 Office or other outpatient visit for the evaluation and management of a new patient,
which requires a medically appropriate history and/or examination and straightforward
medical decision making.When using time for code selection, 15-29 minutes of total time is spent on the date ofthe encounter. 

99203 Office or other outpatient visit for the evaluation and management of a new patient,
which requires a medically appropriate history and/or examination and low level of
medical decision making.When using time for code selection, 30-44 minutes of total time is spent on the date of the encounter.

99204 Office or other outpatient visit for the evaluation and management of a new patient,
which requires a medically appropriate history and/or examination and moderate level of
medical decision making.
When using time for code selection, 45-59 minutes of total time is spent on the date of
the encounter.

99205 Office or other outpatient visit for the evaluation and management of a new patient,
which requires a medically appropriate history and/or examination and high level of
medical decision making.
When using time for code selection, 60-74 minutes of total time is spent on the date of
the encounter.

(For services 75 minutes or longer, see Prolonged Services 99XXX)

Read also : When to use Prolonged services CPT codes

Established Patient

               

99211 Office or other outpatient visit for the evaluation and management of an established
patient, that may not require the presence of a physician or other qualified health care
professional. Usually, the presenting problem(s) are minimal.

99212 Office or other outpatient visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and
straightforward medical decision making.
When using time for code selection, 10-19 minutes of total time is spent on the date of
the encounter.

99213 Office or other outpatient visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and low level
of medical decision making.
When using time for code selection, 20-29 minutes of total time is spent on the date of
the encounter.

99214 Office or other outpatient visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and moderate
level of medical decision making.
When using time for code selection, 30-39 minutes of total time is spent on the date of
the encounter.

99215 Office or other outpatient visit for the evaluation and management of an established
patient, which requires a medically appropriate history and/or examination and high level
of medical decision making.
When using time for code selection, 40-54 minutes of total time is spent on the date of
the encounter.

(For services 55 minutes or longer, see Prolonged Services 99XXX)

6 Thoughts to “2021 E/M Visit CPT codes (New versus Established Patient)”

  1. […] Read also: Code description for New versus Established visit E/M codes […]

  2. […] explicit factor beginning in CPT 1992 is done to assist in selecting the most appropriate level of E/M services. Beginning with CPT 2021 and except for 99211, time alone may be used to select the appropriate code level for the office or […]

  3. […] Read also: New versus Established patient for E/M coding […]

  4. […] D0180 Comprehensive periodontal evaluation – new or established patient […]

  5. […] revised CPT coding guidelines across care settings and services to align with new E/M coding standards. The updates by care setting or service are as […]

  6. […] or outpatient encounters for the same patient. Consultation codes do not differentiate between new or established patients. All services require a medically appropriate history and/or examination. Code selection is based […]

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