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99203

Office or other outpatient visit for the evaluation and management of a new patient, typically 30 minutes.

Code Description

CPT code 99203 is used for office or outpatient evaluation and management visits involving a new patient. This code typically represents a low level of medical decision making and approximately 30 minutes of total time spent on the date of the encounter.

Healthcare providers commonly report CPT 99203 for visits requiring expanded evaluation, review of medical history, and management of uncomplicated or moderately complex concerns.

When to Use 99203

Use CPT 99203 for low-complexity new patient office visits that require additional evaluation and medical decision making beyond a straightforward encounter.

Common examples include:

stable chronic condition evaluation
uncomplicated acute illness
medication management
review of diagnostic testing
low complexity treatment planning

99203 Requirements

Report CPT code 99203 when all of the following apply:

The patient is a new patient
The service is performed in an office or outpatient setting
Medical decision making is low complexity, or
Total physician or qualified healthcare professional time is 30–44 minutes on the date of the encounter

This answers one of the most common search intents.

Time vs. Medical Decision Making

CPT code 99203 may be selected using either:

Low-complexity medical decision making (MDM)
Total physician or qualified healthcare professional time of 30–44 minutes on the date of the encounter

Only one method is required when supported by the documentation.

Documentation Requirements

Documentation should include:

medically appropriate history
medically appropriate examination
low level medical decision making
documented encounter time when billing based on time

Examples

Example 1

A new patient schedules an office visit to establish primary care and discuss well-controlled hypertension. The physician performs a medically appropriate history and examination, reviews previous medical records, continues the patient's current medication, and orders routine laboratory tests. The visit involves low-complexity medical decision making, making CPT code 99203 the appropriate code.

Example 2

A new patient presents with a persistent cough and sinus congestion lasting 10 days. After a medically appropriate history and examination, the physician diagnoses acute bacterial sinusitis, prescribes an oral antibiotic, recommends supportive care, and advises follow-up if symptoms do not improve. The encounter supports low-complexity medical decision making, so CPT code 99203 is reported.