CPT 99214
CPT Code 99214: Office visit, established patient, moderate complexity
Duration
30-39 min
Typical Fee
$120-$220
Type
Outpatient therapy
When to Use CPT 99214
Use CPT code 99214 when billing for office visit, established patient, moderate complexity. This code is used by licensed therapists (LCSW, LPC, MFT, Psychologist) for outpatient sessions.
Adding CPT 99214 to a Superbill
When generating a superbill with CPT 99214, 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 99214:
Documentation Requirements
Document moderate-complexity decision making with multiple conditions or medication adjustments. Include risk assessment and detailed treatment plan.
Common Denial Reasons
- ✗ Documentation does not support moderate complexity — downcoded to 99213
- ✗ Insufficient documentation of prescription drug management or risk
- ✗ Missing updated treatment plan or clinical rationale
Reimbursement Expectations
OON reimbursement typically 50-70% of UCR. Expect $60-$154 from commercial plans.