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Evaluation and Management (E/M) Effective January 1, 2021


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 of
the 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)

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)



















































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