CPT 99205

Office Visit - New Patient - High Complexity

New patient office visit with high level of medical decision making.

60+ minutes
3.50 work RVU
3 requirements

Documentation Requirements

  1. 1Comprehensive new patient evaluation
  2. 2High complexity medical decision making OR 60-74 minutes total time
  3. 3Complex diagnostic/treatment planning

Billing Tips

  • •Appropriate for complex new patient presentations
  • •Document threat to life/function
  • •Time-based: 60-74 total minutes

Frequently Asked Questions

When is 99205 appropriate for a new patient?

99205 is appropriate for new patients with conditions posing threat to life or function, requiring high risk treatment decisions, such as new cancer diagnosis or acute cardiac conditions.

Automate New Patient Level 5 Documentation

Scribeable captures all required elements for CPT 99205 from your patient conversation. Generate compliant notes in seconds.

Common Diagnoses

C34.90I50.23J96.01

Related Specialties

oncologycardiologypulmonologyinternal medicine

Related Procedures

CPT 992131.30 work RVU

Office Visit Level 3

Established patient office visit with low level of medical decision making.

CPT 992141.92 work RVU

Office Visit Level 4

Established patient office visit with moderate level of medical decision making.

CPT 992152.80 work RVU

Office Visit Level 5

Established patient office visit with high level of medical decision making.

CPT 992031.60 work RVU

New Patient Level 3

New patient office visit with low level of medical decision making.

CPT 99205: Office Visit - New Patient - High Complexity

New patient office visit with high level of medical decision making.

Documentation Requirements

  1. Comprehensive new patient evaluation
  2. High complexity medical decision making OR 60-74 minutes total time
  3. Complex diagnostic/treatment planning

Billing Tips

  • Appropriate for complex new patient presentations
  • Document threat to life/function
  • Time-based: 60-74 total minutes

Frequently Asked Questions

When is 99205 appropriate for a new patient?

99205 is appropriate for new patients with conditions posing threat to life or function, requiring high risk treatment decisions, such as new cancer diagnosis or acute cardiac conditions.

Related Procedures

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