99202
Office o/p new sf 15 min
Office or other outpatient visit, new patient, straightforward medical decision making OR 15 to 29 minutes of total time on the date of the encounter.
Published by RVUDoc. Numeric data: CMS RVU26C, effective 2026-07-01. Page updated 2026-09-23. Calculation limits and editorial policy.
Fee-schedule estimate before claim adjustments. Coverage, setting and payer rules still apply.
Billing guidance for 99202 is locked
- When to use it: the exact clinical situations that support billing 99202
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get 99202 downcoded or denied
Payer notes
Medicare and commercial payers cover 99202 routinely. The three-year rule is audited via claims history. Sub-specialty within the same group is treated as the same specialty under the rule for some payers but not others; verify your contract. For telehealth, Medicare allows POS 10 (home) or POS 02 (other) with modifier 95.
Related codes
These include alternative services and possible add-ons. Listing codes together does not establish that they can be billed together; check the applicable edits and payer policy.
See what 99202 adds to your year
Add it to the wRVU calculator with your own volume, or paste a note and let the chart audit check your coding.