CPT 99202 is the lowest-level office or outpatient visit for a new patient. It requires straightforward medical decision making, or at least 15 minutes of the provider’s total time on the date of the visit. It fits a new patient seen for one minor, self-limited problem.
CPT 99202 description
99202 is a new patient office or other outpatient visit with a medically appropriate history and/or examination and straightforward medical decision making. When time is used to choose the level, 15 minutes must be met or exceeded. It became the lowest new patient code in 2021, when 99201 was deleted.
Who counts as a new patient?
Under CPT, a new patient has not received any professional services from the physician or other qualified health care professional, or from another physician or professional of the exact same specialty and subspecialty in the same group practice, within the past three years. Medicare generally treats a nurse practitioner or physician assistant who works with a physician as the same specialty as that physician. If the patient is established, the matching code is 99212.
New patient levels at a glance
| New patient code | Medical decision making | Or total time on the date of the visit |
|---|---|---|
| 99202 | Straightforward | 15 minutes or more |
| 99203 | Low | 30 minutes or more |
| 99204 | Moderate | 45 minutes or more |
| 99205 | High | 60 minutes or more |
Straightforward medical decision making
Two of the three elements must reach at least straightforward:
| Element | Straightforward (99202 / 99212) | Low (99203 / 99213) |
|---|---|---|
| Problems addressed | 1 self-limited or minor problem | 2 or more self-limited or minor problems; or 1 stable chronic illness; or 1 acute, uncomplicated illness or injury; or 1 stable acute illness |
| Data reviewed and analyzed | Minimal or none | At least 1 of: any 2 of reviewing prior external notes, reviewing a test result, or ordering a test; or an assessment requiring an independent historian |
| Risk of patient management | Minimal risk of morbidity from further testing or treatment | Low risk of morbidity from further testing or treatment |
Typical 99202 visits
- A new patient with a minor rash or insect bite needing only reassurance or over-the-counter care.
- A new patient with a cold or other self-limited illness and no tests ordered.
Most new patients bring more than one minor problem, or records to review. When they do, compare the visit with 99203.
Billing 99202 by time
Count the practitioner’s total time on the date of the visit, including:
- Preparing to see the patient, such as reviewing tests
- Getting or reviewing separately obtained history
- Performing a medically appropriate exam
- Counseling and educating the patient, family or caregiver
- Ordering medications, tests or procedures
- Referring and communicating with other professionals (when not separately reported)
- Documenting in the record
- Independently interpreting results (when not separately reported) and coordinating care
Frequently asked questions
What replaced 99201?
99201 was deleted in 2021. 99202 is now the lowest new patient office visit code.
What is the difference between 99202 and 99212?
Both need straightforward MDM. 99202 is for new patients and needs 15 minutes when billed by time; 99212 is for established patients and needs 10 minutes.
Related guides
- CPT 99213: low-complexity established visit
- CPT 99214: moderate-complexity established visit
- 99213 vs. 99214: how to choose the level
- CPT 99215: high-complexity established visit
- CPT 99204: moderate-complexity new patient visit
- CPT 99203: low-complexity new patient visit
- CPT 99205: high-complexity new patient visit
- CPT 99212: straightforward established visit
- CPT 99211: nurse visit for an established patient
- CPT 99417: prolonged office visit add-on
- Primary care billing services
- Medical coding services
CPT is a registered trademark of the American Medical Association. This guide summarizes the office visit E/M rules in effect since 2021, with the 2024 time wording, and the CMS Evaluation and Management Services guide (MLN006764) (opens in a new tab). Payer policies and your documentation decide what is billable.
New patient visits coded consistently?
We review your new patient visits and make sure each level matches what the note supports.