Office & evaluation visits

Doctor visits, established patient checkups, and consultations. The most commonly billed codes on outpatient bills, and the ones most often upcoded.

• 90791Psychiatric diagnostic evaluation (no medical services)
• 90792Psychiatric diagnostic evaluation with medical services
• 90832Psychotherapy, 30 minutes
• 90833Psychotherapy with E/M, 30 minutes
• 90834Psychotherapy, 45 minutes
• 90836Psychotherapy with E/M, 45 minutes
• 90837Psychotherapy, 60 minutes
• 90838Psychotherapy with E/M, 60 minutes
• 90846Family psychotherapy without patient
• 90847Family psychotherapy with patient
• 90853Group psychotherapy
• 92002Ophthalmologic exam, new patient, intermediate
• 92004Ophthalmologic exam, new patient, comprehensive
• 92012Ophthalmologic exam, established patient, intermediate
• 92014Ophthalmologic exam, established patient, comprehensive
• 96130Psychological testing evaluation, first hour
• 96131Psychological testing evaluation, each additional hour
• 96136Psychological/neuropsych test administration, first 30 min
• 96137Psychological/neuropsych test administration, each additional 30 min
• 97161Physical therapy evaluation, low complexity
• 97162Physical therapy evaluation, moderate complexity
• 97163Physical therapy evaluation, high complexity
• 97165Occupational therapy evaluation, low complexity
• 97166Occupational therapy evaluation, moderate complexity
• 97167Occupational therapy evaluation, high complexity
• 99201Office visit, new patient (deleted 2021 — watch for re-billing)
• 99202Office visit, new patient, straightforward (15–29 min)
• 99203Office visit, new patient, low complexity (30–44 min)
• 99204Office visit, new patient, moderate complexity (45–59 min)
• 99205Office visit, new patient, high complexity (60–74 min)
• 99211Office visit, established patient, minimal (nurse visit)
• 99212Office visit, established patient, straightforward (10–19 min)
• 99213Office visit, established patient, low complexity (20–29 min)
• 99214Office visit, established patient, moderate complexity (30–39 min)
• 99215Office visit, established patient, high complexity (40–54 min)
• 99221Hospital inpatient admission, low complexity
• 99222Hospital inpatient admission, moderate complexity
• 99223Hospital inpatient admission, high complexity
• 99231Hospital inpatient subsequent care, stable
• 99232Hospital inpatient subsequent care, responding inadequately
• 99233Hospital inpatient subsequent care, unstable
• 99234Hospital observation or inpatient same-day discharge, low complexity
• 99235Hospital observation or inpatient same-day discharge, moderate
• 99236Hospital observation or inpatient same-day discharge, high
• 99238Hospital discharge day management, ≤30 minutes
• 99239Hospital discharge day management, >30 minutes
• 99241Office consultation (deleted by Medicare — frequently misused)
• 99242Office consultation, low complexity
• 99243Office consultation, moderate complexity
• 99244Office consultation, moderate-to-high complexity
• 99245Office consultation, high complexity
• 99291Critical care, first 30–74 minutes
• 99292Critical care, each additional 30 minutes
• 99304Nursing facility admission, low complexity
• 99305Nursing facility admission, moderate complexity
• 99306Nursing facility admission, high complexity
• 99307Nursing facility subsequent care, stable
• 99308Nursing facility subsequent care, responding inadequately
• 99309Nursing facility subsequent care, significant change
• 99310Nursing facility subsequent care, unstable
• 99315Nursing facility discharge, ≤30 minutes
• 99316Nursing facility discharge, >30 minutes
• 99341Home or residence visit, new patient, low complexity
• 99342Home or residence visit, new patient, moderate complexity
• 99344Home or residence visit, new patient, moderate-to-high
• 99345Home or residence visit, new patient, high complexity
• 99347Home or residence visit, established patient, low complexity
• 99348Home or residence visit, established patient, moderate complexity
• 99349Home or residence visit, established patient, moderate-to-high
• 99350Home or residence visit, established patient, high complexity
• 99354Prolonged office service, first hour (legacy code)
• 99355Prolonged office service, each additional 30 min (legacy)
• 99358Prolonged non-face-to-face service, first hour
• 99359Prolonged non-face-to-face service, each additional 30 min
• 99366Team conference with patient/family present
• 99367Team conference without patient, physician
• 99417Prolonged outpatient E/M, each additional 15 minutes
• 99418Prolonged inpatient E/M, each additional 15 minutes
• 99421Online digital E/M, 5–10 minutes
• 99422Online digital E/M, 11–20 minutes
• 99423Online digital E/M, 21+ minutes
• 99441Telephone E/M, 5–10 minutes
• 99442Telephone E/M, 11–20 minutes
• 99443Telephone E/M, 21–30 minutes