CPT Code 99204: New patient office or other outpatient visit

Learn how to use CPT Code 99204 for new patient visits correctly. Read now to ensure accurate billing, proper documentation, and timely reimbursement.‍

Use Code

Frequently asked questions

CPT code 99204 is used for a new patient office or outpatient visit requiring a medically appropriate history and/or examination and moderate medical decision-making. It typically involves 45–59 minutes spent on the encounter date.

The 99204 code refers to a moderately complex evaluation and management (E/M) service for a new patient. This indicates that the provider conducted a detailed assessment and made moderately complex decisions during the visit.

CPT 99204 is for new patients and involves moderate medical decision-making, while 99214 is for established patients with similar complexity. Documentation and time requirements also differ. A 99214 requires a detailed history, while 99204 requires a comprehensive history and physical exam.