CPT Code 99212: Office visit, established patient, straightforward

Duration

10-19 min

Typical Fee

$60-$120

Type

Outpatient therapy

When to Use CPT 99212

Use CPT code 99212 when billing for office visit, established patient, straightforward. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.

Adding CPT 99212 to a Superbill

When generating a superbill with CPT 99212, 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 99212:

F41.1 - Generalized anxiety disorder F32.1 - Major depressive disorder, single episode, moderate F51.01 - Primary insomnia

Documentation Requirements

Document straightforward medical decision making. Include a focused problem assessment and brief plan update.

Common Denial Reasons

✗ Complexity exceeds straightforward level — should use 99213
✗ Time documentation does not support the 10-19 minute range
✗ Minimal documentation does not justify the service

Reimbursement Expectations

OON reimbursement typically 50-65% of UCR. Expect $30-$78 from commercial plans.

Related Guides

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