October 9, 2025
The CPT code 99201 was historically used for a Level 1 office or outpatient visit for a new patient.Β
It described a brief encounter with a problem-focused history, exam, and straightforward medical decision-making, usually lasting about 10 minutes. However, this code was deleted in 2021 as part of the American Medical Associationβs (AMA) restructuring of Evaluation and Management (E/M) services.
The AMA redesigned office and outpatient E/M coding guidelines to make documentation simpler and more reflective of clinical care. The major updates included:
For encounters that would have previously qualified under 99201, providers now use CPT code 99202.
Today, E/M office visit codes for new patients (99202β99205) are selected based on:
This means billing teams and providers must ensure workflows are updated to reflect these requirements. Accurate documentation of time or MDM ensures compliance and reduces denials.
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While 99201 is used for straightforward cases, other codes address more complex situations:
Choosing the correct office visit CPT code depends on the time spent, the complexity of decision-making, and the level of examination required.
Feature | 99201 (Deleted) | 99202 (Replacement) |
Status | Deleted in 2021 | Active |
Patient Type | New Patient | New Patient |
Medical Decision-Making | Straightforward | Straightforward |
Time Requirement | ~10 minutes | 15β29 minutes |
Documentation Focus | Problem-focused history & exam + MDM | Total time or MDM |
Usability | No longer valid for billing | Must be used for the lowest-level new visits |
Alignment with 2025 E/M | Not applicable | Fully compliant |
The 99201 CPT code is no longer valid and has been replaced by 99202, which is now the lowest-level new patient office visit code. This shift reflects the AMAβs effort to simplify E/M coding and make it more clinically meaningful by focusing on time or medical decision-making rather than outdated documentation requirements.
For providers and billing teams, adopting 99202 ensures compliance, prevents claim denials, and aligns with the latest 2025 E/M guidelines. Accurate coding is not just about reimbursement; itβs about maintaining integrity, reducing administrative burden, and supporting high-quality patient care.
Because it overlapped with 99202 and offered little distinction, making it unnecessary under updated E/M coding rules.
CPT 99202 is now used for straightforward new patient office visits, based on either MDM or time.
15β29 minutes of provider time on the date of the patient encounter.
No, it has been deleted since 2021 and should not be used on claims.
CPT 99201 and 99202 were similar, but 99201 required problem-focused history and exam, while 99202 required expanded problem-focused history/exam and slightly more complex decision-making. With current updates, CPT 99202 now covers the scope that 99201 previously did and more.
Codes range from 99202β99205, with levels based on time or MDM complexity.
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