What is the CPT code for office visit?
Asked by: Ernest Ratke | Last update: December 23, 2025Score: 4.1/5 (57 votes)
What is the difference between a 99213 and an 99214?
The primary difference between CPT code 99213 and 99214 lies in the complexity and time involved. While 99213 is for a low level of medical decision-making, 99214 is used for moderate complexity, requiring a higher level of medical decision-making and more extensive history and examination.
What is office visit cpt code 99201?
CPT code 99201 is used for new patient office visits, representing a problem-focused history and examination with straightforward medical decision making. New patients are defined as those who have not received professional services from the same physician or specialty group within the past three years.
What is a 99213 office visit?
CPT® code 99213: Established patient office or other outpatient visit, 20-29 minutes.
What is the difference between CPT code 99204 and 99203?
The difference between CPT code 99203 and 99204 lies in the complexity and time. 99203 is used for visits of low complexity (30-44 minutes), while 99204 is used for moderate complexity (45-59 minutes).
VIDEO # 1 HOW TO CODE FOR AN OFFICE VISIT
What is CPT code 99204 charge?
CPT code 99204 is designated for new patient office or outpatient visits that require a moderate complexity in medical decision-making or 45-59 minutes of patient encounter time. Proper documentation and accurate code selection are crucial for maximizing reimbursement with CPT code 99204.
What is the CPT code for new patient office visit?
CPT® code 99203: New patient office or other outpatient visit, 30-44 minutes. As the authority on the CPT® code set, the AMA is providing the top-searched codes to help remove obstacles and burdens that interfere with patient care.
What is a 99214 office visit?
CPT defines a 99214 or level-IV established patient visit as one involving a detailed history, detailed examination and medical decision making of moderate complexity.
How to code an office visit?
To report, use 99202. Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making.
What is CPT code 20610?
CPT code 20610 is used for a procedure where a healthcare provider drains fluid from or injects medication into a joint or bursa without using ultrasound guidance. This code typically applies to treatments for conditions like arthritis or bursitis to relieve pain and inflammation.
What is the CPT code for most common office visit?
99213/99214 – General Office Visits
CPT code 99213 is used for low-complexity office visits, while 99214 is used for moderate-complexity office visits.
What is the CPT code for office visit consult?
office consultation
For non-Medicare patients (unless otherwise instructed by a payor), office or other outpatient consultations are reported with codes 99241– 99245.
What is a complex office visit?
Complex visits are defined as those with over two diagnoses (the mean of diagnoses made per visit) and/or those with over three prescription medications (the mean of medications prescribed per visit).
What is CPT code 99212 used for?
CPT® code 99212: Established patient office or other outpatient visit, 10-19 minutes.
What is the code for regular office visit?
Office or Other Outpatient Services CPT® Code range 99202- 99215. The Current Procedural Terminology (CPT) code range for Office or Other Outpatient Services 99202-99215 is a medical code set maintained by the American Medical Association.
What is the CPT code for office visit 99213?
The 99213 code is specifically used for office visits that involve moderate medical decision-making and complexity. It is suitable for patients with established conditions or those with new, uncomplicated symptoms. These services encompass a range of primary care services that address the immediate needs of patients.
What is the ICD 10 code for office visit?
Encounter for general adult medical examination without abnormal findings. Z00. 00 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
How do you know if it's 99213 or 99214?
The American Medical Association (AMA) outlines time requirements for these codes, reflecting the complexity of services rendered. CPT Code 99213: Generally involves 20 minutes spent on patient care. CPT Code 99214: Typically requires approximately 30 minutes spent with the patient.
When not to use modifier 25?
Modifier 25 should not be used when: ❌ The sole purpose of the encounter is for the procedure (e.g., lesion removal), and there is no documented medical necessity for a separate E/M service.
What is CPT code 99214 charge?
CPT code 99214 is used for an office or other outpatient visit where the healthcare provider evaluates and manages an established patient. The visit must involve a detailed history, a comprehensive examination, and moderate complexity in medical decision-making.
How to code office visits?
To report an office or other outpatient visit for a new patient, you'll choose from E/M codes 99201-99205. As this article mentioned previously, office/outpatient visits include history, clinical examination, and medical decision-making (MDM) as the three key components for code selection.
What is the CPT code for office consultation?
Office or Other Outpatient Consultations CPT® Code range 99242- 99245. The Current Procedural Terminology (CPT) code range for Office or Other Outpatient Consultations 99242-99245 is a medical code set maintained by the American Medical Association.
What is the difference between outpatient and office visits?
The main difference between outpatient and office visits is the cost. You'll receive the same care from your doctor regardless of the facility being used, but outpatient facilities sometimes charge patients additional hospital affiliation fees.