CPT 99242
Office consultation, new/established, straightforward (commercial)
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 payment status
- Office / clinic-based
- CMS addendum
- Not on ASC addenda
- Typical setting
- Physician office or clinic (POS 11).
What is CPT code 99242?
CPT 99242 is a CPT procedure code. Its official CMS 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 payable in an ambulatory surgery center (ASC)?
CPT 99242 is typically performed in a physician office or clinic (place of service 11) rather than reimbursed as an ASC facility procedure.
Where is CPT 99242 typically performed?
Physician office or clinic (POS 11).
Reference information compiled from the CMS April 2026 ASC payment addenda (AA, BB, EE). Codes, descriptors, and ASC payment status change with each CMS update. This is a coding reference, not billing, coding, or legal advice. Always verify against the current CMS addenda and individual payer policy before billing. CPT is a registered trademark of the American Medical Association.