Office visit · CPT 99214

What is CPT code 99214?

Established-patient office visit, moderate complexity.

By Justin Feldstein · Reviewed 2026-06-15

What it covers

A more involved visit with a doctor you've seen before, with more history, a broader exam, or decisions about a condition that needs real management, like adjusting medications, ordering and interpreting tests, or handling two or more ongoing problems at once. It sits one step above the routine follow-up, so it should reflect genuinely more work and judgment, not just a longer wait or a chattier appointment.

When you'd see it

Common when you're managing a chronic condition, came in with several concerns, or the doctor spent meaningful time weighing options on your case.

Roughly what it costs

$130–$300 commonly billed

A ballpark on the billed amount. After insurance or a negotiated rate, what you owe is often far lower. Always compare against your Explanation of Benefits (EOB).

What's usually billed with it

Frequently paired with labs, imaging, or an EKG (93000) when the visit involves managing or working up a condition; each is its own line.

99214 vs 99213

99213 is the routine low-complexity follow-up, so a short, simple visit shouldn't be billed at 99214 just because you have a chronic condition on file. See 99213 (established-patient, low complexity).

What to watch for

99214 is frequently scrutinized for upcoding, being billed at a higher level than the visit actually warranted. If your appointment was short and simple, it's worth asking why it wasn't the lower-level 99213.

Specific things to question

• Whether a short, simple appointment was billed at this moderate level instead of 99213.
• Whether the chart documents the multiple problems or medication changes that justify 99214.
• Whether it was pushed up to 99215 without high-complexity decision-making.

How to check this charge on your own bill

Find 99214 on your itemized bill and match it against your EOB. Confirm it appears only once, that any bundled services aren't also billed separately, and that the amount matches what your insurer says it allowed. If something doesn't line up, that's a fair question for the billing office.