99201 CPT Code: Complete Guide to New Patient Evaluation

What Is CPT Code 99201?

CPT code 99201 was a medical billing code used to report evaluation and management (E/M) services for new patients. Specifically, it applied to visits that involved a straightforward medical issue with minimal complexity. This code was used when a patient was seen for the first time and the visit required only a brief history, limited physical examination, and straightforward clinical decision-making.

Why CPT Code 99201 Was Deleted

The American Medical Association (AMA) officially deleted CPT code 99201 effective January 1, 2021. The primary reason for its removal was its overlap with CPT code 99202. Both codes covered low-complexity new patient visits, making 99201 largely redundant. In an effort to streamline documentation requirements and reduce confusion, the AMA eliminated 99201 as part of its E/M coding updates.

Replacement for CPT Code 99201

Healthcare providers now use CPT code 99202 to report new patient visits that would have previously qualified under 99201. CPT 99202 covers office or outpatient visits for the evaluation and management of new patients involving a medically appropriate history and/or examination and straightforward medical decision-making.

CPT Code Description Complexity Status
99201 New patient visit with minimal complexity Minimal Deleted (2021)
99202 New patient visit with low complexity Low Active

When You Might Still See CPT Code 99201

Although CPT 99201 is no longer used for billing, you may still come across it in certain contexts. These include archived patient records, older billing statements, or insurance documentation for services rendered before 2021. It’s important to know that any use of CPT 99201 for services after January 1, 2021, is considered outdated and not valid for reimbursement.

Common Questions About CPT 99201

Can CPT 99201 Still Be Used?

No. CPT 99201 was deleted in 2021 and is no longer valid for use in medical billing or documentation.

What Should Be Used Instead of CPT 99201?

Use CPT code 99202 for low-complexity new patient evaluation and management services.

Is It a Problem if I See CPT 99201 on a Medical Bill?

If the service occurred before 2021, there is no issue. For any services after that date, contact the healthcare provider or billing department for clarification.

Summary: 

  • CPT 99201 was used for new patient visits with minimal complexity.
  • It was officially deleted in 2021 due to redundancy with CPT 99202.
  • CPT 99202 is now the appropriate code for low-complexity new patient visits.
  • 99201 may still appear in historical records but should not be used for current services.
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