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Chiropractors: 99201 Deleted effective 01/01/2021
Blue Cross Blue Shield of Kansas·KS · Chiropractic·Provider News
Effective date
Jan 1, 2021
We identified it
Jun 19, 2026
Summary
CPT code 99201 for new patient office visits has been deleted effective January 1, 2021, with new patient codes now ranging from 99202-99205. Additionally, E&M code selection guidelines have changed to use medical decision making or time instead of previous criteria, and modifier 25 usage with new patient E&M codes will result in 75% payment reduction.
Action Required
Immediately: Billing team must update billing software to remove CPT 99201 and restrict new patient E&M codes to 99202-99205 only. Update encounter forms and EMR templates to reflect new E&M guidelines requiring medical decision making or time-based documentation. Configure system to flag modifier 25 usage with new patient E&M codes as it will reduce reimbursement to 75% of maximum allowable payment. Train providers on new 2021 E&M documentation requirements and ensure time is documented when used for code selection.