CPT Code 99201: Deleted Code – Current New Patient Office Visit Coding

Important: CPT 99201 Was Deleted January 1, 2021

The code described in the source (99201: new patient, problem-focused history/exam, straightforward MDM) no longer exists. The AMA eliminated all level 1 codes (99201, 99211) and restructured E/M coding around Medical Decision Making (MDM) or Time.

Current New Patient Office Visit Codes (2021+)

Code	MDM Level	Typical Time	Key Requirements
99202	Straightforward	15–29 min	Minimal problem (1 self-limited); minimal data; minimal risk
99203	Low	30–44 min	2+ self-limited OR 1 stable chronic OR 1 acute uncomplicated; limited data; low risk
99204	Moderate	45–59 min	1+ chronic w/ exacerbation OR 2+ stable chronic OR 1 acute complicated; moderate data/risk
99205	High	60–74 min	1+ severe chronic exacerbation OR 1 acute severe; extensive data; high risk

How to Select the Correct Code

1. Determine MDM level using 2 of 3 elements: Problems addressed, Data reviewed/ordered, Risk of complications.
2. OR use Time: Total time on date of encounter (face-to-face + non-face-to-face). Document start/stop or total.
3. History/Exam: No longer scored; perform "medically appropriate" history/exam for the problem.

Medicare Note

Medicare follows CPT guidelines but may have specific documentation requirements. 99201 was never a Medicare code (they used G-codes for brief visits).

Common Pitfalls

• Using deleted codes → claim denials, audit risk.
• Undercoding (defaulting to 99202) → revenue loss.
• Overcoding without MDM documentation → fraud risk.
• Time-based coding without documenting total time & activities.

Resources

• AMA CPT E/M Guidelines (free with registration)
• CMS MLN Matters articles on E/M changes
• Specialty-specific coding guides (AAFP, ACP, AAP, etc.)

Always code based on current year CPT. 99201 is historical only.