CPT 99205: Office Visit - New Patient - High Complexity
New patient office visit with high level of medical decision making.
Documentation Requirements
- Comprehensive new patient evaluation
- High complexity medical decision making OR 60-74 minutes total time
- 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.