New patient office visit: how much does Medicare pay?

Nationally, the Q3 2026 Physician Fee Schedule pays $117.57 in an office (non-facility) setting and $71.48 in a facility setting for 99203. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.

Procedure · Updated Aug 1, 2026

New patient office visit: CPT code and Medicare rate

A first office visit with a clinician who has not seen you in the last three years. Level 3 (99203) is the usual choice for a new patient with one straightforward problem; the level rises with the complexity of the problem and the work involved.

Also called: office visit new patient, first visit with a doctor, establishing care, new patient appointment.

Usually billed as

99203 New Patient Office Visit, Level 3

Office (non-facility): $117.57
Facility: $71.48

National amounts for the Q3 2026 release (July 1 – September 30, 2026), using geographic index values of 1.000. Your local rate differs — open the code page for the locality breakdown.

New-patient levels run 99202 through 99205. Which one is billed depends on the medical decision-making involved or the total time spent, not on the length of the appointment slot.

Related codes

Codes worth checking before you settle on 99203.

Code	What it covers	Office	Facility
99202	New Patient Office Visit, Level 2	$75.15	$41.08
99204	New Patient Office Visit, Level 4	$177.36	$116.90
99205	New Patient Office Visit, Level 5	$236.81	$160.32

A dash means the code has no national amount in this release — it may be carrier-priced, bundled, or not separately payable. That is never the same as $0.

Common questions

New patient office visit: which code is it?: 99203 — New Patient Office Visit, Level 3. A first office visit with a clinician who has not seen you in the last three years. Level 3 (99203) is the usual choice for a new patient with one straightforward problem; the level rises with the complexity of the problem and the work involved.
New patient office visit: how much does Medicare pay?: Nationally, the Q3 2026 Physician Fee Schedule pays $117.57 in an office (non-facility) setting and $71.48 in a facility setting for 99203. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.
New patient office visit: what else affects the billing?: New-patient levels run 99202 through 99205. Which one is billed depends on the medical decision-making involved or the total time spent, not on the length of the appointment slot.

Need the rate where you practice?

Every code page carries the full locality breakdown, the RVU and GPCI inputs, and the release that answered.

Open the code page

Keep exploring

All procedures How Medicare pays Office vs. facility rates Check a medical bill

This page maps everyday language to the code a claim normally carries. It is general information about how Medicare prices a service, not coding advice for a specific claim — the correct code always depends on what was actually documented and performed.

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