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CPT® 99205: new patient office visit, high MDM

CPT® 99205 reports an office or other outpatient visit for a new patient. Since 2021 it is selected by one of two paths: high medical decision making, or at least 60 minutes of the practitioner’s total time on the date of the encounter.

Patient
New
Medical decision making
High
Minimum total time
60 minutes (2021 range 60–74)
Same level, established patient
99215
One level down
99204

Selecting 99205 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 99205, two of the three must meet or exceed the high level. The AMA's Table 2 defines that level as follows; the data element has its own category rules, listed in the source.

What the high level looks like for each MDM element
ElementHigh level
Problems addressed
  • 1 or more chronic illnesses with severe exacerbation, progression, or side effects of treatment
  • 1 acute or chronic illness or injury that poses a threat to life or bodily function
Data reviewed and analyzedExtensive (must meet 2 of 3 categories)
Risk of patient managementHigh risk of morbidity from additional diagnostic testing or treatment
  • Drug therapy requiring intensive monitoring for toxicity
  • Decision regarding elective major surgery with identified patient or procedure risk factors
  • Decision regarding emergency major surgery
  • Decision regarding hospitalization
  • Decision not to resuscitate or to de-escalate care because of poor prognosis

Selecting 99205 by time

When the level is selected by time, 99205 requires at least 60 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 60–74 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.

When a time-based visit runs past 99205, CPT® code 99417 is reported for each additional 15 minutes; 99205 with one unit covers 75–89 minutes. Medicare uses HCPCS code G2212 instead, counted beyond the maximum time of 99205, so one unit covers 89–103 minutes under CMS guidance.

What the note has to show

Because two of the three elements must be met, a note that supports 99205 by MDM has to make at least two of them visible at the high level: the problems addressed and their status, the data reviewed or ordered, or the management decisions that carry the risk. A note that supports 99205 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

Questions

How many minutes is 99205?

When the level is selected by time, 99205 requires at least 60 minutes of the practitioner’s total time on the date of the encounter; the 2021 code set listed it as 60–74 minutes. The level can also be reached by high medical decision making regardless of time.

What level of medical decision making is 99205?

High. Two of the three MDM elements (problems addressed, data reviewed and analyzed, and risk of patient management) must meet or exceed the high level.

Is 99205 for new or established patients?

New patients. The established-patient code at the same level is 99215.

When is prolonged service time added to 99205?

Only when the visit is selected by time and the total time exceeds 99205. CPT® 99417 is reported for each additional 15 minutes (99205 with one unit covers 75–89 minutes). Medicare uses HCPCS G2212 instead, counted beyond the maximum time of 99205 (one unit covers 89–103 minutes under CMS guidance).

Sources

  1. 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)
  2. 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

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