Established patient office visit evaluation and management codes
Level | Requirement (at least 2 of the 3 must be at the billed level) | Time (minutes) | RVUs | ||||
---|---|---|---|---|---|---|---|
History | Examination | Medical decision-making | |||||
HPI | ROS | PFSH | Organ systems | Diagnoses/complexity/risk | |||
Level 1 (E1) 99211 | 1–3 | None | None | 1 | Problem-focused | 5 | 0.18 |
Level 2 (E2) 99212 | 1–3 | 1 | None | 1 | Straightforward | 10 | 0.48 |
Level 3 (E3) 99213 | ≥ 4 | 1 | None | 2–7 | Low complexity | 15 | 0.97 |
Level 4 (E4) 99214 | ≥ 4 | 2–9 | 1 | 2–7 (with detail) | Moderate complexity | 25 | 1.5 |
Level 5 (E5) 99215 | ≥ 4 | ≥ 10 | 2–3 | ≥ 8 | High complexity | 40 | 2.11 |
HPI = history of present illness; ROS = review of systems; PFSH = past medical, family, and social history; RVU = Relative Value Unit