Floating Contact
Text Message
+1 (916) 299-5335

99242 CPT code: 2026 billing, MDM, time, and documentation guide

CPT 99242 outpatient consultation billing 2026 hero banner: straightforward MDM or 20-minute time threshold, request-service-report consultation test, Medicare's 2010 non-recognition policy, BCBS Texas dropping consultation codes November 2024, and modifier 25 same-day E/M rules, from ClaimMax RCM.

CPT 99242 reports an office or other outpatient consultation for a new or established patient. Select the level with straightforward medical decision making, or at least 20 minutes of qualifying total time on the encounter date. The encounter has to meet consultation requirements separately, and the payer has to recognize outpatient consultation codes. Getting the […]