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Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.
2025 CPT code 99243
Office or other outpatient consultation; low medical decision making or at least 30 minutes of total time.
2025 CPT code 99242
Office or other outpatient consultation; straightforward medical decision making or at least 20 minutes of total time.
2025 CPT code 99254
Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.
2025 CPT code 99255
Inpatient or observation consultation for a new or established patient, requiring a medically appropriate history and/or examination and high-level medical decision making (MDM).If using total time, 80 minutes must be met or exceeded.
2025 CPT code 99245
Office or other outpatient consultation; high level medical decision making or 55+ minutes of total time.
2025 CPT code 99253
Inpatient or observation consultation; low medical decision-making or 45+ minutes total time.
2025 CPT code 99244
Office or other outpatient consultation; medically appropriate history and/or examination and moderate level of medical decision making; or total time of 40 minutes or more.
2025 CPT code 80505
Pathology clinical consultation for a highly complex clinical problem, requiring comprehensive review of patient history and medical records, and a high level of medical decision making. When using time for code selection, 41-60 minutes of total time is spent on the date of the consultation.
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