Code 99203 represents a new patient appointment that’s at least 30 minutes in duration.
October 24, 2024 • Updated on November 13, 2026
By the Headway Editorial Team • Clinically reviewed by the Headway Clinical Team
14 min read
By the Headway Editorial Team • Clinically reviewed by the Headway Clinical Team
The 99203 code is an E/M code used by prescribing providers. For other E/M codes, visit this overview.
Code 99203 represents a new patient visit that involves at least 30 minutes of total time, but no more than 44 minutes. It’s a prescriber code, which means it’s most commonly used by psychiatrists or nurse practitioners.
This is is how the American Medical Association defines 99203 in the official CPT codebook:
CPT code 99203: New patient office visit, minimum 30 minutes
Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.
As a prescriber, you can bill insurance according to time or medical decision-making (MDM). Make sure to include sufficient documentation to support the method you choose.
If you spent 30-44 minutes on a new client’s case but the case was especially complex or high-risk, or involved reviewing or analyzing a lot of data, you may use a higher CPT code, including 99204 (moderate MDM), or 99205 (high MDM).
It’s important to use the code that most accurately reflects the time you spent with the patient to treat their condition, and ensure that documentation for the session supports the chosen code.
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There are three considerations that go into MDM selection: problems addressed, data reviewed, and risk of complications. If at least two of the three domains meet the bar for low MDM, code 99203 may be appropriate. Here’s what that could look like in practice:
| Element | What counts as low-level | Psychiatric example |
|---|---|---|
| 1. Number and complexity of problems addressed | A single, stable condition | A new patient who reports mild anxiety but no other psychiatric concerns |
| 2. Amount and/or complexity of data reviewed and analyzed | Reviewing a limited amount of data | Reviewing records from the client’s previous provider |
| 3. Risk of complications, morbidity, or mortality | A treatment decision that presents minimal risk | Referring the client to psychotherapy |
CPT code 99203 is a new patient appointment of 30-44 minutes with low MDM. Other time frames for a new patient should be coded with 99202 (at least 15 minutes), 99204 (at least 45 minutes), or 99205 (at least 60 minutes).
All time spent on a client’s case on the date of service counts — not just the time you spent with them face-to-face. That could include reviewing records or ordering tests, for example.
If total time falls between 45 and 59 minutes, use code 99204. For 60 to 74 minutes of work, use code 99205.
Documentation for 99203 is essentially the same as other E/M codes, but geared toward a new patient.
Here’s a new patient example note:
Patient Name: Quinn Morales
Date of Service: 03/27/20
Patient DOB: 5/18/1982
Appointment Time: 8:30am-9:00am
Place of Service: Patient was located at their home at 123 Main St Anywhere US 12345
Provider was located at their office: 456 Storybook Ln Hollywood CA 96852
This session was provided via a HIPAA compliant interactive audio/video platform. The patient consented to this telemedicine encounter.
The total time I spent caring for this patient today was 41 minutes which included: interviewing the client, documenting, reviewing the patient's responses to questionnaires, discussing treatment plans, coordinating care, prescription management and counseling the client on managing her mental health.
Chief Complaint: Patient presents with stable ADHD and is here for a medication refill.
HPI: 42-year-old male with a history of ADHD presents for a follow-up to refill his medication. The patient states that his symptoms are well-controlled with Strattera and denies any recent issues or concerns. He reports no significant side effects from the medication and states that his focus and concentration have improved. He denies mood changes, anxiety, or depression.
ROS:
PMH/PSH:
Medications:
Allergies: No known drug allergies.
Substance Use Assessment: Denies use of tobacco, alcohol, or recreational drugs.
MSE:
Physical Examination:
Time spent: 30 minutes face-to-face.
Electronically signed by:
[Provider name, Credentials, Date signed]
_____________________________________________________________________________________________
Rationale information is not required in your note; it is provided for educational purposes only.
Number and Complexity of Problems Addressed: Low, 1 stable chronic illnesses
Data Reviewed/Analyzed: none
Risk: Moderate: Moderate, prescription drug management
Rationale: The client displays Low number & complexity of problems with one stable chronic illness, No data reviewed, and Moderate risk for prescription management.
Level of MDM: Low
CPT Codes Selected: 99203
Reimbursement rates for sessions billed with 99203 will vary depending on factors like the specific payer contract, your geographic location, and type of therapy license. Headway providers can check the portal for rates with each insurance provider.
This document is intended for educational purposes only. It is designed to facilitate compliance with payer requirements and applicable law, but please note that the applicable laws and requirements vary from payer to payer and state to state. Please check with your legal counsel or state licensing board for specific requirements.
As long as all other criteria are met, code 99203 can generally be billed for telehealth sessions. However, it’s always worth confirming, as policies can vary by payer.
Sessions that take place over telehealth may also require additional documentation elements, such as a CPT modifier code and a place-of-service code. The CPT modifier 95 signifies that an appointment took place via synchronous telehealth, while place-of-service codes (such as 02 and 10) describe exactly where the client was located during the remote session.
If you’re treating an existing patient, you should use 99213 instead. A new patient is someone you have not seen in the last three years.
At Headway, we know insurance billing can be confusing. That’s why we make it as easy as possible for our providers, offering rapid credentialing services, automatic benefits verification, templates for compliant documentation, billing and claims support, clawback and audit protection, and more — all for free. When it’s easier (and more profitable) for you to accept insurance, it’s easier for your clients to get care. We think that’s a win-win.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
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Understand the ins and outs of CPT codes to help make documentation and billing more efficient — and give you more time to focus on other areas of your practice.
Headway strives to simplify billing insurance so you can focus on providing care. Read our comprehensive guide to mental health billing.
Understand the ins and outs of CPT codes to help make documentation and billing more efficient — and give you more time to focus on other areas of your practice.
