What is cpt code 90000 and 90001?

CPT code 90000 is used for a new patient office visit, while CPT code 90001 is used for an established patient office visit. Both codes are used for the evaluation and management of a patient's condition, but there are some key differences between the two.

CPT code 90000 is used for a new patient office visit when the patient is new to the practice or has not been seen by the provider for at least 3 years. This code includes a more comprehensive evaluation of the patient's condition, including a review of their medical history, a physical examination, and any necessary diagnostic tests.

CPT code 90001 is used for an established patient office visit when the patient has been seen by the provider within the last 3 years. This code includes a less comprehensive evaluation of the patient's condition, focusing on the current problem or concern. A physical examination may or may not be performed, depending on the nature of the problem.

The level of complexity of the evaluation and management determines the specific CPT code that is used. There are three levels of complexity:

Level 1: Simple office visit

Level 2: Intermediate office visit

Level 3: Complex office visit

The provider will determine the level of complexity based on the following factors:

The nature of the problem or condition

The amount of time spent with the patient

The extent of the evaluation and management performed

The amount of medical decision-making required

CPT codes 90000 and 90001 are used to bill for office visits with a physician or other qualified healthcare professional. The codes are based on the type of visit (new patient or established patient) and the level of complexity of the visit.