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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

Documentation Requirements

Documentation should include:

  • medically appropriate history

  • medically appropriate examination

  • low level medical decision making

  • documented encounter time when billing based on time

Common Billing Mistakes

Common billing mistakes for CPT 99203 include:

  • undercoding higher complexity visits

  • incomplete medical decision making documentation

  • incorrect patient status selection

  • insufficient encounter documentation

Related CPT Codes

99202- Office or other outpatient visit for a new patient, typically 15 minutes.

99204- Office or other outpatient visit for a new patient, typically 45 minutes.

99205- Office or other outpatient visit for a new patient, typically 60 minutes.

FAQ

Is CPT 99203 for new patients?

Yes. CPT 99203 is used only for new patient office or outpatient visits.

What is the typical time for CPT 99203?

The typical total time for CPT 99203 is 30 minutes.

What level of medical decision making is required?

CPT 99203 requires low level medical decision making.

Can CPT 99203 be billed based on time?

Yes. Providers may bill CPT 99203 using total encounter time when properly documented.

Patient Type

New Patient

Typical Time

MDM Level

30 Minutes

Low