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ESTABLISHED OFFICE PATIENTS
 

 

Effective January 1, 2021, there are new guidelines for new and established office visits. For information on the 2021 guidelines, click here.

Established Office Patients (99211-99215)

These are the most common patient encounters on the planet. The established office patient codes are used to bill for established patients being seen in the office. An established patient is defined as someone who has been seen by you or a physician in the same specialty in your group within the previous three years. There are five levels of care for these visits with the requirements for medical decision-making or time shown below.

For a detailed exploration of the 2021 guidelines including clinical examples of each level of care for new and established office visits and a deep dive into the new table of medical decision-making, consider signing up for one of our 2021 update courses here.

E/M Code History Physical Exam MDM Time $
99211 A medically appropriate history and/or exam   NA $23.03
99212 SF 10 - 19 $56.88
99213 Low 20 - 29 $92.47
99214 Mod 30 - 39 $131.20
99215 High 40 - 54 $183.19

 

 

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