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LEVEL 4 NEW
OFFICE VISIT (99204) 
 

 

Effective January 1, 2021, the rules for these encounters have changed. They are now documented using the 2021 E/M guidelines NOT the 1995 or 1997 guidelines.

Level 4 New Office Visit (99204)

This is the most popular code used to bill for new patients being seen in the office.  Internists selected the 99204 code for 51.93% of these encounters in 2019.  The 2021 Medicare allowable reimbursement for this level of care is $169.93 and it is worth 2.6 work RVUs.  This level of care requires moderate complexity MDM or a total of 45 - 59 minutes devoted to the encounter on the date of the visit.

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

 

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