Home > E/M Codes > 99212

99212

Office or other outpatient visit for the evaluation and management of an established patient, typically 20 minutes.

Code Description

CPT code 99213 is used for office or outpatient evaluation and management visits involving an established patient. This code typically represents low level medical decision making and approximately 20 minutes of total time spent on the date of the encounter.

It is one of the most frequently reported E/M codes in outpatient practice.

When to Use 99213

Common examples include:

  • chronic condition management

  • uncomplicated acute illnesses

  • medication monitoring

  • follow-up evaluations

Documentation Requirements

  • medically appropriate history

  • medically appropriate examination

  • low level medical decision making

  • documented encounter time when applicable

Common Billing Mistakes

  • selecting 99213 when documentation supports a higher level

  • insufficient medical decision making documentation

  • inaccurate time reporting

Related CPT Codes

99212- Established Patient Office Visit, 10 Minutes

99214- Established Patient Office Visit, 30 Minutes

99215- Established Patient Office Visit, 40 Minutes

FAQ
Is CPT 99213 for established patients?

Yes. CPT 99213 is used for established patient office visits.

What is the typical time for CPT 99213?

Typically 20 minutes.

What level of medical decision making is required?

Low level medical decision making.

Patient Type

Established Patient

Typical Time

MDM Level

20 Minutes

Low