What Is the Appropriate CPT Code for a New Patient Office Visit?

Understanding the correct CPT (Current Procedural Terminology) code for a new patient office visit is crucial for accurate medical billing and reimbursement. As of 2025, the CPT code range for new patient office visits is 99202–99205, each corresponding to different levels of service complexity and time spent. For detailed CPT code guidance, check out EZ Settle Solutions Services.

CPT Code 99203: New Patient Office Visit

CPT Code 99203 applies to new patient office visits that require a medically appropriate history and/or examination and a low level of medical decision-making. Typically, this code is used when the physician spends 30–44 minutes on the date of the encounter.

Key Components:

• History and/or Examination: Conduct a medically appropriate history and/or examination.
• Medical Decision-Making: Complexity is low.
• Time Spent: 30–44 minutes on the date of the encounter.

For more details, see What is the CPT Code Used for Performing an MRI of the Brain With and Without Contrast?.

Comparison of New Patient CPT Codes (99202–99205)

The level of service is determined by the complexity of medical decision-making and the time spent on the encounter.

For guidance on medical billing, see Medical Billing Services.

 Understanding Medical Decision-Making (MDM)

Medical Decision-Making (MDM) is a critical component in selecting the appropriate CPT code. It involves assessing the complexity of establishing a diagnosis, selecting management options, and evaluating the risk of complications or morbidity.

For authoritative guidance, refer to the American Medical Association.

 Tips for Accurate Coding

• Documentation: Thoroughly document the history, examination, and medical decision-making process.
• Time Tracking: Accurately record the time spent on the encounter.
• Stay Updated: Regularly review updates from the American Medical Association and other reputable sources.

By understanding and correctly applying CPT codes, healthcare providers can ensure accurate billing and reimbursement, improving the financial health of their practices while maintaining compliance.