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

Duration

30-44 min

Typical Fee

$110-$200

Type

Outpatient therapy

Note: New patient E/M.

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:

F41.1 - Generalized anxiety disorder F32.1 - Major depressive disorder, single episode, moderate F90.9 - Attention-deficit hyperactivity disorder, unspecified F43.10 - Post-traumatic stress disorder, unspecified

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

Reimbursement Expectations

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

Related Guides

CPT Code 90791: Psychiatric Diagnostic Evaluation Guide5 min read
How to Create a Superbill: Complete Guide8 min read
Telehealth Therapy Billing: CPT Codes, Modifiers, and Superbills6 min read

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