CPT 99213: Office Visit - Established Patient - Low Complexity
Established patient office visit with low level of medical decision making.
Documentation Requirements
- Chief complaint and HPI
- Low complexity medical decision making OR 20-29 minutes total time
- Problem assessment and management
- At least one of: limited data review, low risk treatment
Billing Tips
- Document 2 or more self-limited problems, or 1 stable chronic illness
- Time-based billing: 20-29 total minutes on encounter date
- Include data reviewed (labs, imaging, outside records)
Frequently Asked Questions
What qualifies for 99213 vs 99214?
99213 requires low MDM complexity or 20-29 minutes total time. 99214 requires moderate MDM or 30-39 minutes. Scribeable analyzes your documentation and suggests the appropriate level.
Can I use time-based billing for 99213?
Yes, if you spend 20-29 minutes total time on the encounter date (including pre-visit review, face-to-face time, and documentation), you can bill 99213 based on time alone.