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99244 CPT code: 2026 requirements, MDM, time and payer rules

CPT 99244 outpatient consultation billing 2026 hero banner: moderate MDM or 40-minute time threshold, Medicare's non-recognition of the 99242-99245 family since 2010, the 40-minute crosswalk trap between 99203/99204 for new patients and 99214/99215 for established, no prolonged-service add-on at this level, and payer-specific consultation recognition rules, from ClaimMax RCM.

The 99244 CPT code reports an office or other outpatient consultation for a new or established patient. It requires a medically appropriate history and/or examination and moderate medical decision making, or at least 40 minutes of total time on the date of the encounter. Medicare Part B does not recognize 99244 for payment. Active and […]