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Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 45-59 minutes of total time is spent on the date of the encounter.
CPT code 99204 represents an office or other outpatient visit for the evaluation and management of a new patient. This level 4 code requires a medically appropriate history and/or examination and a moderate level of medical decision-making.
In our guide to CPT Code 99204, we’ll teach you about this straightforward complexity evaluation and management procedure code, 99204 guidelines for billing, and the CPT Code 92204 reimbursement rate for Medicare in 2024.
The 99204 CPT code is used for billing office or other outpatient hospital services to evaluate and manage the new patient, which requires medically necessary history and an exam that entails a moderate level of MDM.
CPT code 99204 is a specific medical billing code used to report a general outpatient visit for a new patient. This code is part of the Evaluation and Management codes, which are essential for accurately documenting and billing for medical services.
The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider spends 45 or more minutes of total time on the encounter on a single date.
The description of CPT code 99204 was changed 01 01-2008 to: “Office or other outpatient visit for evaluation and management of a new patient, which requires these three key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity.
CPT Code 99204 represents an office or outpatient visit for the evaluation and management of a new patient that entails a medically appropriated history and/or examination, along with a moderate level of medical decision-making.
The 99204 CPT code is used for new patient office or outpatient visits. It requires a medically appropriate history and/or examination and moderate level of medical decision making. The code is applicable for encounters where the total time spent is between 45 and 59 minutes.
CPT code 99204 is a new patient appointment of at least 45 minutes with moderate MDM. Other time frames for a new patient should be coded with (at least 15 minutes), (at least 30 minutes), or [99205] (at least 60 minutes).