CPT^® Code Set

99201 OFFICE OUTPT NEW 10 MIN

Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Physicians typically spend 10 minutes face-to-face with the patient and/or family.

Code Relationships:

Method	Evaluation - action (qualifier value)
Method	Management - action (qualifier value)

(Use 99354 in conjunction with 99201-99215, 99241-99245, 99304-99350)

Code Context

CPT^® Code Set

Evaluation and Management Services

Office or Other Outpatient Services

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The following codes are used to report evaluation and management services provided in the physician's office or in an outpatient or other ambulatory facility. A patient is considered an outpatient until inpatient admission to a health care facility occurs.

To report services provided to a patient who is admitted to a hospital or nursing facility in the course of an encounter in the office or other ambulatory facility, see the notes for initial hospital inpatient care (page 12) or initial nursing facility care (page 22).

For services provided by physicians in the emergency department, see 99281-99285.

For observation care, see 99217-99220.

For observation or inpatient care services (including admission and discharge services), see 99234-99236.

New Patient Office or Other Outpatient Services

Description	Code(s)
OFFICE OUTPT NEW 10 MIN	99201
OFFICE OUTPT NEW 20 MIN	99202
OFFICE OUTPT NEW 30 MIN	99203
OFFICE OUTPT NEW 45 MIN	99204
OFFICE OUTPT NEW 60 MIN	99205

Relative Value Units:

Calculated for Utah (84660)

Facility: 0.55 (Hospital, etc.)

Non-Facility: 0.9 (Office, etc.)

RVU Components (by modifier)

Modifier	Work	Practice Expense	Malpractice Expense	Total
(none)	0.39	0.48	0.03	0.9

Practitioner Work Component: 0.39

Pre-Service	Intra-Service	Post-Service	Total Time
2 min	10 min	5 min	17 min

Work RVU Components (by modifier)

Modifier	Base RVU	Budget Neutrality Adjustor	National Unadjusted Work RVU	Work GCPI	Adjusted Work RVU
(none)	0.45	.8806	0.4	0.9770	0.39

Practice Expense: 0.48

Clinical Labor (Non-Facility) - Direct Expense

Staff	Staff Rate	Pre Time	Intra Time	Post Time	Total Time
RN/LPN/MTA	$0.37 / min	0 min	24 min	0 min	24 min

Equipment (Non-Facility) - Direct Expense

Item	Purchase Price	Expected Life	Total Time
table, exam	$1338.17	15 years	24 min
otoscope-ophthalmoscope (wall unit)	$694	10 years	24 min

Supplies (Non-Facility) - Direct Expense

Item	Unit Price	Quantity	Unit	Amount
pack, EM visit	$2.98	1	pack	$2.98

Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.

MP RVU Components (by modifier)

Modifier	Base RVU	National Unadjusted PE RVU	PE GCPI	Adjusted PE RVU
(none)	0.52	0.52	0.9220	0.48

Malpractice Component: 0.03

PE RVU Components (by modifier)

Modifier	Base RVU	National Unadjusted PE RVU	PE GCPI	Adjusted PE RVU
(none)	0.03	0.03	0.8410	0.03

Fees

NCCI Edits

CPT® Code Set

Evaluation and Management Services

Office or Other Outpatient Services

New Patient Office or Other Outpatient Services

CPT^® Code Set