99203
Office o/p new low 30 min
Office or other outpatient visit, new patient, low-level medical decision making OR 30-44 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 99203 is locked
- When to use it: the exact clinical situations that support billing 99203
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get 99203 downcoded or denied
Payer notes
Medicare and Medicare Advantage plans audit new-patient claims using prior claim history. Commercial payers including Aetna and BCBS occasionally request copies of the prior provider's records to verify true new-patient status. For telehealth new patients, Medicare requires the patient be in their home (POS 10) or another approved originating site (POS 02); commercial payer rules vary.
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 99203 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.