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SCHEDULE APT
PT FORMS
infectious disease doctor
SELF PAY
VISIT TYPE
1 Problem-Focused
2 Expanded Problem-Focused
3 Detailed, Low Complexity
4 Comprehensive, Moderate Complexity
5 Comprehensive, High Complexity
NEW PATIENT
99201 - $ 100.00
99202 - $ 140.00
99203 - $ 180.00
99204 - $ 220.00
99205 - $ 260.00
ESTABLISHED PATIENT
99211 - $ 75.00
99212 - $ 115.00
99213 - $ 155.00
99214 - $ 195.00
99215 - $ 235.00
TELEHEALTH
99421 (5 – 10 minutes)
$50.00
99422 (11 – 20 minutes)
$65.00
99423 (21 minutes or more)
$80.00
NO-SHOW FEE
$25.00
per missed visit
selfpay
RESOURCES
resources
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