CPT 99203 vs 99213 Cost: Are You Being Overbilled for a New Patient Visit?

Evidence-Based Updated April 19, 2026 Confidence: High

CPT 99203 vs 99213 Cost: Are You Being Overbilled for a New Patient Visit?

Sean Walters
Sean Walters
Senior Claims Strategist · ClaimsValidated
🎯 Appeal Difficulty: 3 / 10  ·  Success Rate: 85%

Quick Answer: CPT 99203 is for new patients. CPT 99213 is for established patients. Both codes represent a standard level 3 office visit. Providers charge up to 30% more for the 99203 code. If you have visited the same practice in the last three years, billing you as a new patient is a coding error. You can appeal this charge and lower your bill.

Real Scenario: The "Three-Year" Trap

Setting
Dermatology Clinic
Last seen 2 years ago
What Happened
Routine skin check
Saw a different doctor
Billed At
$450
Using New Patient 99203
Correct Code (99213)
$142
Medicare baseline estimate
Estimated Overcharge
$308 saved
The patient cited the CMS "Three-Year Rule" in their appeal letter. The clinic realized they were in the same practice group and immediately corrected the code to 99213.

Your 99203 Savings Calculator

Enter what you were billed for CPT 99203. We will calculate your potential overcharge based on the fair price.

Estimated Overcharge
Appeal Success Probability
99203 Fair Estimate
$173
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Your overcharge is moderate. A pre-written appeal letter using the three-year rule will usually fix this error quickly.

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This bill is significantly inflated. Get our full bundle to combat facility fees and new patient coding errors.

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The Gap: 99213 vs 99203

The only difference between these two codes is your history with the clinic. They both cover the exact same level of medical complexity. Here is the breakdown.

Criteria CPT 99213 (Established) CPT 99203 (New Patient)
Patient Status Seen in the last 3 years Not seen in the last 3 years
Typical Time 20 to 29 minutes 30 to 44 minutes
Medicare Base (2026) ~$95 ~$115
Common Error Code is generally safe if time matches Billed incorrectly for existing patients

Medical offices make more money on the 99203 code. They will often default to this code if they update their computer systems or if you see a new doctor in their network.

Red Flag Auditor: 3 Signs of Upcoding

🚩 Red Flag #1: The Three-Year Rule Violation

CMS rules state that you are an established patient if you have received services from that exact practice in the last 36 months.

Tactical Leverage: Check your bank statements or portal history. If you had an appointment there two years ago, tell their billing department to re-code your bill to 99213.
🚩 Red Flag #2: Same Practice, Different Doctor

If you see Dr. Smith today, and Dr. Jones next year in the exact same office, you are an established patient. The clinic shares one tax ID.

Tactical Leverage: Clinics often blame their software for this mistake. Do not accept this excuse. Force them to manually adjust the code to 99213.
🚩 Red Flag #3: CO-97 Denial Code on EOB

Sometimes a provider will bill 99203 along with another procedure using a Modifier 25. Your insurance may deny it with a CO-97 code.

Tactical Leverage: A CO-97 denial means the visit was bundled into the procedure. This is a billing error on their end. Do not pay this balance.

Frequently Asked Questions

Related CPT Code Guides

Methodology & Data Sources

Pricing estimates on this page are derived from the following sources:

  • CMS Physician Fee Schedule: national unadjusted rates
  • AMA CPT® Guidelines: E&M code definitions and documentation requirements
  • Geographic Practice Cost Index (GPCI): regional rate adjustments

Last updated: April 19, 2026. Confidence level for comparison pricing data: High. This page does not constitute legal or medical advice.

Sean Walters
Sean Walters
Senior Claims Strategist · ClaimsValidated

Sean is an expert in medical claims across E&M, radiology, and surgical billing. He built the ClaimsValidated appeal methodology to help patients fight back and recover overcharges. Learn at SeanWalters.com, find experts at ClaimsRank, or use tools at ClaimsValidated.

Not affiliated with CMS, AMA, or any insurer. For educational purposes only.