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NEW OFFICE PATIENTS
 

 

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.

New Office Patients (99202-99205)

These codes are used to bill for new patients being seen in the office.   A new patient is defined as someone who has never been seen by you or a physician in the same specialty in your group OR who has not been seen by you or a physician in the same specialty in your group within the last three years.  There are four levels of care for this type of encounter with the requirements for time and medical decision-making 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 $
99202 A medically appropriate history and/or exam SF 15 - 29 $73.97
99203 Low 30 - 44 $113.75
99204 Mod 45 - 59 $169.93
99205 High 60 - 74 $224.36

 

 

 

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