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ESTABLISHED OFFICE PATIENTS
 

 

Established Office Patients (99211 - 99215)

These are the most common patient encounters on the planet. The established office patient codes are used to bill for established patients being seen in the office. An established patient is defined as someone who has been seen by you or a physician in the same specialty in your group within the previous three years. There are five levels of care for these visits with the requirements for medical decision-making or time shown below.

E/M Code History Physical Exam MDM Time $*
99211 A medically appropriate history and/or exam   NA $23.03
99212 SF 10 - 19 $56.88
99213 Low 20 - 29 $92.47
99214 Mod 30 - 39 $131.20
99215 High 40 - 54 $183.19

*Medicare physician fee schedule: 2022

 

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