CPT 99205 is the highest new-patient office visit level: about an hour, high complexity, typically a serious or complicated diagnosis, multiple chronic conditions, or decisions about major treatment. It is common in oncology, cardiology and neurology first visits.

What the price covers

When a hospital lists it, this is the price at a hospital-owned clinic or outpatient department, often with a facility fee on top of the clinician's fee. Any tests, imaging or procedures ordered are separate.

Why prices vary

Prices for the same visit level differ mainly by ownership: hospital-owned practices add facility fees; independent practices do not. Academic medical centers list the highest charges. Cash prices are usually far below the gross charge.

Questions to ask

What is the self-pay price for 99205 including any facility fee?
Could the visit be booked at an independent practice with the same specialist?
What is included, and what will be billed separately?

New patient office visit (about 60 minutes) near you