All ASC CPT codes
Clinic/Office – E&M Consult · CPT

CPT 99242

Office consultation, new/established, straightforward (commercial)

Last reviewed August 2026 · DataLily AI data team

Pilot Analysis

Get the complete CPT 99242 analysis

Tell us where to send it. Our team will prepare an analysis of CPT 99242 covering what payers reimburse across markets and where your rate may sit, and email it to you within 5-10 business days. Need it faster? Book a demo.

No spam, your analysis and the occasional benchmark worth reading. Unsubscribe anytime.

CPT 99242 at a glance

Code
99242
Code type
CPT
Short descriptor
Office consultation, new/established, straightforward (commercial)
Category
Clinic/Office – E&M Consult
ASC eligibility
Office / clinic-based
Typical setting
Physician office or clinic (POS 11).

What is CPT code 99242?

CPT 99242 is a CPT procedure code for office consultation, new/established, straightforward (commercial). Its official short descriptor is "Office consultation, new/established, straightforward (commercial)". In the ASC context it is grouped under Clinic/Office – E&M Consult.

Is CPT 99242 eligible in an ambulatory surgery center (ASC)?

CPT 99242 is typically performed in a physician office or clinic (place of service 11) rather than in an ambulatory surgery center.

Where is CPT 99242 typically performed?

Physician office or clinic (POS 11).

Reference information about ASC eligibility and typical procedure setting. Codes, descriptors, and ASC-eligibility status change over time. This is a coding reference, not billing, coding, or legal advice. Always verify against current guidance and individual payer policy before scheduling or billing. CPT is a registered trademark of the American Medical Association. Read the DataLily AI data methodology.

Related CPT codes
Browse all ASC CPT codes