99212
Office o/p est sf 10 min
Office or other outpatient visit, established patient, straightforward medical decision making OR 10 to 19 minutes of total time on the date of the encounter. Reserved for truly minor, single-problem encounters; most established-patient encounters meet 99213 or 99214 criteria.
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 99212 is locked
- When to use it: the exact clinical situations that support billing 99212
- Documentation checklist: the 4 elements your note needs before submitting
- Common pitfalls: the 4 mistakes that get 99212 downcoded or denied
Payer notes
Medicare and commercial payers cover 99212 routinely. The 99213-to-99212 ratio is sometimes audited; clinicians with high 99212 rates relative to peers may be flagged for under-coding (rare audit pattern, but real). Most clinicians find that careful 2021-guideline-aligned coding moves many 99212 encounters to 99213.
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 99212 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.