CPT Code 99202 is integral to medical billing, representing evaluation and management (E/M) services for new patients. Understanding its application ensures accurate billing and compliance.
Understanding CPT Code 99202
CPT code 99202 pertains to the evaluation and management (E&M) of new patients in an outpatient setting. This code is designated for straightforward medical decision-making and typically involves 15-29 minutes of total time spent on the date of the encounter.
Key Components of CPT 99202:
- History and Examination: A medically appropriate history and/or examination is required.
- Medical Decision Making (MDM): Involves straightforward MDM, indicating minimal complexity in diagnosing and managing the patient’s condition.
- Time Requirement: Total time spent on the date of the encounter ranges from 15 to 29 minutes.
Billing Guidelines:
When billing for CPT 99202, it’s essential to document the following:
- Patient’s Chief Complaint: The primary reason for the visit.
- Relevant History: Pertinent medical, family, and social history.
- Examination Findings: Objective data gathered during the physical examination.
- Assessment and Plan: Clinical impressions and the proposed management plan.
Accurate documentation ensures compliance and facilitates appropriate reimbursement.
Reimbursement Rates:
As of 2025, the Medicare reimbursement rate for CPT 99202 is approximately $69.87.
Quick RCM Services:
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Understanding and correctly implementing CPT code 99202 is crucial for healthcare providers to ensure accurate billing and optimal reimbursement. Partnering with a proficient revenue cycle management company like Quick RCM can streamline this process, allowing providers to focus on delivering quality patient care.
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