Note: CPT® code 99201 was officially deleted as of January 1, 2021, and is no longer valid for reporting. It was retired due to low usage and redundancy with other Evaluation and Management (E/M) codes.
What Was CPT 99201?
Prior to its deletion, CPT® code 99201 was used to report an office or other outpatient visit for the evaluation and management of a new patient. It represented the lowest level of complexity and required:
- A problem-focused history
- A problem-focused examination
- Straightforward medical decision making (MDM)
This code typically applied to visits involving:
- A single, minor complaint (e.g., mild rash, common cold, or medication refill)
- Minimal clinical risk
- A brief, focused history and physical exam
- No need for additional diagnostic testing or follow-up management
99201 was appropriate when documentation requirements for higher-level new patient codes (such as 99202 or 99203) were not met.
Why Was CPT 99201 Deleted?
As part of the 2021 E/M coding revisions, the American Medical Association (AMA) and Centers for Medicare & Medicaid Services (CMS) removed 99201 to:
- Reduce administrative burden and simplify documentation
- Eliminate redundancy, since 99201 and 99202 were clinically similar
- Shift the focus from history/exam elements to medical decision making or total time
What to Use Instead of CPT 99201
For visits that would previously have been reported with 99201, providers should now report CPT 99202, which applies to:
- A medically appropriate history and/or physical exam
- Straightforward MDM, or
- 15–29 minutes of total time spent on the date of the encounter
Be sure to document all required elements to support accurate coding under current E/M guidelines.
Stay Up to Date with OptiMantra
OptiMantra helps providers stay compliant with evolving CPT guidelines, including discontinued codes like 99201. Our intelligent system supports you by:
- Supports accurate CPT code selection based on documentation of MDM or total time.
- Offering smart templates for problem-focused or preventive visits
- Helps providers stay aligned with current CPT guidelines, including discontinued codes
- Streamlining documentation with note templates and clinical macros
- Reduces manual errors with customizable billing tools and claims workflows
By embedding up-to-date logic and flexible templates into your workflow, OptiMantra helps you maintain compliance, improve efficiency, and focus more on patient care—not paperwork.
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