CPT Code 99203: Office visit, new patient, moderate complexity

When to Use CPT 99203

Use CPT code 99203 when billing for office visit, new patient, moderate complexity. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 99203 to a Superbill

When generating a superbill with CPT 99203, include the ICD-10 diagnosis code, date of service, fee charged, amount paid, and your NPI number. Superbilled pre-fills common therapy CPT codes automatically.

Common ICD-10 Pairings

These diagnosis codes are frequently used alongside CPT 99203:

Documentation Requirements

Document moderate-level medical decision making with review of pertinent data. Include assessment of at least one new or worsening condition.

Common Denial Reasons

• ✗ Documentation complexity does not support moderate level — should be 99202 or 99204
• ✗ Insufficient data points reviewed or documented
• ✗ Missing new patient intake elements

Got one of these on a remittance? Decode the denial code.

Reimbursement Expectations

OON reimbursement typically 50-70% of UCR. Expect $55-$140 from commercial plans.