What this is, in plain language
A first visit with a clinician you have not seen recently, about 15–29 minutes of total provider time or straightforward decision-making.
Why a clinician orders it
Establishing care or evaluating a single simple new problem.
Medical necessity — what insurers usually look at
Usually covered with a copay or coinsurance. New patient codes apply only if you have not been seen by that provider (or same-specialty provider in the group) within three years.
New to this? Read what medical necessity means and how to appeal a denial.
Documentation to ask about
- ✓Reason for the visit
- ✓Total time or MDM elements
- ✓Provider's in-network status
Questions for your provider
- ?Is the provider in-network for my plan?
- ?Will any labs ordered today go to an in-network lab?
Why this code is in our seed set
Common new-patient E/M code in the CMS Top 200 Ranked by Services.
Validated against
- •AMA CPT code 99202 descriptor (2021 E/M revision)
- •CMS Top 200 Level I CPT Codes Ranked by Services
Important: AuraCode is an educational tool. It does not provide medical, legal, or insurance advice, claims decisions, or approval guarantees. Final coverage depends on your specific plan, eligibility, diagnosis, submitted documentation, and your insurer's review.