{
    "code": "99203",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99203/2020/A",
    "release_specific_url": "https://localishealth.com/cpt/99203/2020/C",
    "description": "A low-to-moderate complexity visit for a patient the practice has not seen recently — for example, a new patient establishing care for a stable condition or presenting with a single uncomplicated problem, such as seasonal allergies. Total visit time typically runs about 30 to 44 minutes; new-patient visits generally take longer than an established-patient visit at the same level because no prior chart exists to build on.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99203 in Q3 2020?",
        "text": "Medicare paid $109.35 for CPT 99203 in the office (non-facility) setting and $77.23 in a facility under the Q3 2020 Physician Fee Schedule, effective July 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2020, when it decreased 0.5%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2020,
        "quarter": "C",
        "label": "Q3 2020",
        "effective": "July 1 – September 30, 2020",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 109.35,
        "facility": 77.23,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.42,
        "practice_expense_non_facility": 1.48,
        "practice_expense_facility": 0.59,
        "malpractice": 0.13
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0896,
    "source": {
        "label": "Physician relative value file (Q3 2020)",
        "cms_url": "https://www.cms.gov/files/zip/rvu20c-updated-06192020.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2020/C",
        "file": "PPRRVU20_V0618.csv",
        "row": 17141,
        "sha256": "ebde66539c09d959dffb822c31f25e7c77955ac2e54e8c120994bef894ac5342"
    },
    "modified_at": "2026-08-04T03:09:46+00:00"
}