CPT 99213

Office Visit - Established Patient - Low Complexity

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

15-20 minutes
1.30 work RVU
4 requirements

Documentation Requirements

  1. 1Chief complaint and HPI
  2. 2Low complexity medical decision making OR 20-29 minutes total time
  3. 3Problem assessment and management
  4. 4At 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.

Automate Office Visit Level 3 Documentation

Scribeable captures all required elements for CPT 99213 from your patient conversation. Generate compliant notes in seconds.

Common Diagnoses

Z00.00J06.9I10E11.9

Related Specialties

primary careinternal medicinepediatrics

Related Procedures

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 992042.60 work RVU

New Patient Level 4

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

CPT 99213: Office Visit - Established Patient - Low Complexity

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

Documentation Requirements

  1. Chief complaint and HPI
  2. Low complexity medical decision making OR 20-29 minutes total time
  3. Problem assessment and management
  4. 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.

Related Procedures

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