99204
Office or other outpatient visit for the evaluation and management of a new patient, moderate level of medical decision making
Which specialties bill 99204
Practices that commonly submit 99204. See how Copay funds each specialty.
Reimbursement context
There is no single fee for 99204. Reimbursement varies by payer, geography, and contract, and each payer sets its own rate. What is consistent and sourced is payment timing: Medicare Advantage plans must pay 95% of clean claims within 30 days, and timely filing limits differ by payer. See the payer pages for sourced detail rather than an assumed dollar amount.
Relevant payers
How Copay purchases 99204 claims
Copay purchases your eligible claims at the service-line level, including 99204, and pays you the next business day regardless of how long the payer takes to adjudicate. You connect your billing software once and submit claims exactly as you do today. It is non-recourse, so a denied eligible claim is Copay's loss, not yours.
99204, answered
CPT 99204 is office or other outpatient visit for the evaluation and management of a new patient, moderate level of medical decision making.
Urgent Care practices commonly bill 99204.
There is no single fee. Reimbursement for 99204 varies by payer, geography, and contract. See the payer pages for sourced payment-timing context rather than an assumed amount.
All CPT/HCPCS codes · How Copay purchases claims · Glossary: Claim Adjudication
Descriptor reflects the CMS/AMA descriptor as used across Copay’s specialty pages. Confirm exact wording and payable status against the licensed AMA CPT data file and CMS fee schedule before relying on it for billing.
Get paid on your 99204 claims the next business day.
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