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The rules for new office patients are changing starting on January 1, 2021. The information below will NO LONGER apply to these encounters.

Click HERE to see our 2021 E/M Coding Update Course.

Level 1 New Patient Office Visit (99201)

This is the lowest level of care for a new patient in the office.  Internists used this code for only 0.34% of new office patients in 2018.  Usually the presenting problems are self-limited or minor.  The Medicare allowable reimbursement (2020) for this level of care is $46.56 and it is worth 0.48 work RVUs according to the latest CMS fee schedule.

Documentation requires THREE out of THREE of the following:

1)  Problem Focused History
2)  Problem Focused Exam
3)  Straightforward Medical Decision-Making

Or 10 minutes spent face-to-face with the patient if coding based on time.  The appropriate documentation must be included.

Clinical Example

This topic is covered in more detail in our web-based E/M coding courses.

New Office Patients

New Office Patients
  Related Topics


Basic Course Preview
Now that the consult codes have been eliminated for Medicare patients, the new office patient visit has become the most common outpatient initial encounter. Learn exactly what needs to be documented for each level of care for these visits. All levels of care are discussed.    
  For mutliple users, consider an E/M Compliance Web Portal.


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