CPT® 99202: new patient office visit, straightforward MDM
CPT® 99202 reports an office or other outpatient visit for a new patient. Since 2021 it is selected by one of two paths: straightforward medical decision making, or at least 15 minutes of the practitioner’s total time on the date of the encounter.
Selecting 99202 by medical decision making
MDM has three elements: the number and complexity of problems addressed, the amount and/or complexity of data to be reviewed and analyzed, and the risk of complications and/or morbidity or mortality of patient management. To report 99202, two of the three must meet or exceed the straightforward level. The AMA's Table 2 defines that level as follows; the data element has its own category rules, listed in the source.
| Element | Straightforward level |
|---|---|
| Problems addressed |
|
| Data reviewed and analyzed | Minimal or none |
| Risk of patient management | Minimal risk of morbidity from additional diagnostic testing or treatment |
Selecting 99202 by time
When the level is selected by time, 99202 requires at least 15 minutes of the physician's or qualified health care professional's total time on the date of the encounter, face-to-face and non-face-to-face. The 2021 code set listed it as 15–29 minutes; the current CPT® code set is the authority for the exact descriptor. Activities that count, and the ones that do not, are listed in the total time section of the guide.
What the note has to show
Because two of the three elements must be met, a note that supports 99202 by MDM has to make at least two of them visible at the straightforward level: the problems addressed and their status, the data reviewed or ordered, or the management decisions that carry the risk. A note that supports 99202 by time has to record the total time on the date of the encounter. The MedChartScan E/M audit reads the note for these elements and shows the passages it used, so the level can be checked against the text before the claim goes out.
Nearby codes
- Same level for an established patient: 99212
- One level up: 99203
- All office and outpatient codes: the code table in the guide
Questions
How many minutes is 99202?
When the level is selected by time, 99202 requires at least 15 minutes of the practitioner’s total time on the date of the encounter; the 2021 code set listed it as 15–29 minutes. The level can also be reached by straightforward medical decision making regardless of time.
What level of medical decision making is 99202?
Straightforward. Two of the three MDM elements (problems addressed, data reviewed and analyzed, and risk of patient management) must meet or exceed the straightforward level.
Is 99202 for new or established patients?
New patients. The established-patient code at the same level is 99212.
Sources
- CPT® Evaluation and Management (E/M) Office or Other Outpatient and Prolonged Services code and guideline changes, effective January 1, 2021 (opens in a new tab) — American Medical Association (with March 9, 2021 technical corrections)
- Evaluation and Management Services (MLN006764), May 2026 revision (opens in a new tab) — Centers for Medicare & Medicaid Services
Last reviewed September 29, 2026 · CPT® is a registered trademark of the American Medical Association · Full guide: How E/M coding works