CPT Code 99242: Office or Outpatient Consultation for a New or Established Patient

No. CPT code 99242 requires a consultation request from another provider; it cannot be billed for self-referred patients.

No. You can choose this code based on either straightforward medical decision making or documented total time (20–29 minutes) spent on the patient’s care on the encounter date.

Yes, many payers allow CPT 99242 for telehealth consultations. Always confirm telehealth billing guidelines with individual payers.