Office visit codes

Office visits are billed with five-digit “evaluation and management” (E/M) codes in the 992xx family, and the exact code sets the price. The two things worth checking across all of them: upcoding — a short, simple visit billed at a higher-complexity level than the work warranted — and new-patient codes used when you'd actually been seen by the practice within the last three years. The codes below cover both new and established patients, from a quick nurse check to a long, complex appointment; each page explains what its level really means and how to tell if yours was billed too high.

• 99202 New-patient office visit, straightforward complexity
• 99203 New-patient office visit, low-to-moderate complexity
• 99204 New-patient office visit, moderate complexity
• 99205 New-patient office visit, high complexity
• 99211 Established-patient visit, minimal (often nurse or staff)
• 99212 Established-patient office visit, straightforward complexity
• 99213 Established-patient office visit, low complexity
• 99214 Established-patient office visit, moderate complexity
• 99215 Established-patient office visit, high complexity