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99204Office Visit

New patient office visit, 45 minutes

Prior authorization
Not commonly required

What this is, in plain language

An office visit with a clinician you have not seen recently, lasting about 45 minutes of total provider time.

Why a clinician orders it

Establishing care or addressing a new concern.

Medical necessity — what insurers usually look at

Office visits are usually covered with a copay or coinsurance. Make sure the provider is in-network to avoid balance bills.

Documentation to ask about

  • Reason for visit
  • Provider network status

Questions for your provider

  • ?Is the provider in-network for my plan?
  • ?Will any labs ordered today be sent to an in-network lab?
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.