# CPT 99204

> Medicare paid $167.09 for CPT 99204 in the office (non-facility) setting and $132.09 in a facility under the Q1 2020 Physician Fee Schedule, effective January 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. Across payment localities, the office amount is $153.00–$216.68 and the facility amount is $123.03–$177.55. This is a 0.1% increase from the previous quarter.

## What it is

Long New Patient Office Visit

## Selected release

- Release: Q1 2020 (2020 A)
- Effective: January 1 – March 31, 2020
- Status indicator: A
- Office (non-facility) national allowed amount: $167.09
- Facility national allowed amount: $132.09
- Sequestration: not applied

## RVUs and formula

- Work RVU: 2.43
- Office (non-facility) practice expense RVU: 1.98
- Facility practice expense RVU: 1.01
- Malpractice RVU: 0.22
- Conversion factor: 36.0896
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2020)
- CMS file: https://www.cms.gov/files/zip/rvu20a-updated-01312020.zip
- Parsed file: PPRRVU20_Jan.csv, row 17,058
- Canonical page: https://localishealth.com/cpt/99204/2020/A
- Release-specific citation URL: https://localishealth.com/cpt/99204/2020/A
- Last significant update: 2026-08-13T15:22:50+00:00