Evaluation and Management (E/M)

New Patient:

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

CPT 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.

CPT 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.

CPT 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.

CPT 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:

CPT 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.

CPT 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.

CPT 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.

CPT 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.

CPT 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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