CPT 99215

Office Visit - Established Patient - High Complexity

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

40+ minutes
2.80 work RVU
4 requirements

Documentation Requirements

  1. 1Comprehensive history of present illness
  2. 2High complexity medical decision making OR 40-54 minutes total time
  3. 3Highly complex problem assessment
  4. 4High risk treatment or decision making

Billing Tips

  • •Document 1+ chronic illness with severe exacerbation OR acute illness threatening life/function
  • •High risk: drug therapy requiring intensive monitoring, decision regarding hospitalization
  • •Extensive data review or independent interpretation
  • •Time-based: 40-54 total minutes

Frequently Asked Questions

When is 99215 appropriate?

99215 is appropriate for patients with acute/chronic illnesses posing threat to life or function, or requiring high risk treatment decisions. Examples: cancer treatment planning, unstable heart failure, acute respiratory failure.

Automate Office Visit Level 5 Documentation

Scribeable captures all required elements for CPT 99215 from your patient conversation. Generate compliant notes in seconds.

Common Diagnoses

C34.90I50.23J96.01E11.65

Related Specialties

internal medicinecardiologyoncologypulmonology

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 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 99215: Office Visit - Established Patient - High Complexity

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

Documentation Requirements

  1. Comprehensive history of present illness
  2. High complexity medical decision making OR 40-54 minutes total time
  3. Highly complex problem assessment
  4. High risk treatment or decision making

Billing Tips

  • Document 1+ chronic illness with severe exacerbation OR acute illness threatening life/function
  • High risk: drug therapy requiring intensive monitoring, decision regarding hospitalization
  • Extensive data review or independent interpretation
  • Time-based: 40-54 total minutes

Frequently Asked Questions

When is 99215 appropriate?

99215 is appropriate for patients with acute/chronic illnesses posing threat to life or function, or requiring high risk treatment decisions. Examples: cancer treatment planning, unstable heart failure, acute respiratory failure.

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