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99291

Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes

Evaluation & Management Critical Care High Complexity 10.20 Total RVUs
Quick Reference
For evaluation and management of critically ill or injured patients in intensive care settings

💬 Plain Language Explanation

What this means

This is critical care - intensive care provided to a critically ill or injured patient. Your doctor spent significant time (at least 30 minutes) providing life-saving or intensive care.

Why you might see this

This code is used when you received critical care in an intensive care unit (ICU) or emergency situation. It's for patients who are critically ill or injured and require intensive monitoring and treatment.

Common context

Used for critically ill or injured patients requiring intensive care, often in ICU settings or emergency situations.

What to ask your provider

"'Why was critical care necessary? How much time was spent providing critical care?'"

Relative Value Units (RVUs)

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Work RVU
4.50
Physician effort
PE RVU
5.20
Practice expense
MP RVU
0.50
Malpractice
Total RVU
10.20
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

For evaluation and management of critically ill or injured patients in intensive care settings

Time Requirement
First 30-74 minutes of critical care time

Common Scenarios

ICU patient initial assessment and management
Unstable vital signs requiring continuous monitoring
Multi-system failure requiring intensive intervention
Post-operative critical care management
Life-threatening emergency stabilization

Documentation Requirements

  • High complexity medical decision making
  • Continuous monitoring documentation
  • Interventions and medications administered
  • Time spent and critical care procedures
  • Assessment of critical illness severity

Coding Guidelines

Common Modifiers

25 Separate E&M from procedure on same day
59 Distinct procedural service
91 Repeat clinical observation

Bundling Rules

  • Includes all critical care evaluation and management
  • Includes interpretation of monitoring and labs
  • Includes direct bedside care and time

Exclusions

  • Do not bill with other E&M on same day without modifier 25
  • Do not use for non-critically ill patients

Coding Notes

Time-based coding - requires accurate documentation
Includes all activities performed during critical care
Use 99292 for each additional 30 minutes
Global period: 0 days

Clinical scenarios

ICU patient initial assessment and management
ICU patient initial assessment and management
When to use:For evaluation and management of critically ill or injured patients in intensive care settings
  • High complexity medical decision making
  • Continuous monitoring documentation
  • Interventions and medications administered
Unstable vital signs requiring continuous monitoring
Unstable vital signs requiring continuous monitoring
When to use:For evaluation and management of critically ill or injured patients in intensive care settings
  • High complexity medical decision making
  • Continuous monitoring documentation
  • Interventions and medications administered
Multi-system failure requiring intensive intervention
Multi-system failure requiring intensive intervention
When to use:For evaluation and management of critically ill or injured patients in intensive care settings
  • High complexity medical decision making
  • Continuous monitoring documentation
  • Interventions and medications administered

Who are you?

Code Details

Code 99291
Category Evaluation & Management
Subcategory Critical Care
Total RVUs 10.20

Medicare Pricing

PFS
2025 National Rate
$265.56
Facility
$205.72
Non-Facility
$265.56
RVU Breakdown
Work RVU:4.50PE RVU:3.27MP RVU:0.44Total RVU:8.21CF:$32.3465Global Days:XXX
OPPS Details
APC:5041Status:J2Copayment:—
ⓘ Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 99291?

CPT 99291 is the billing code for "Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes". For evaluation and management of critically ill or injured patients in intensive care settings

How much does Medicare pay for CPT 99291?

Medicare pays approximately $265.56 for CPT 99291 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

What are the RVUs for CPT 99291?

CPT 99291 has a total RVU of 10.20, broken down as: Work RVU 4.50, Practice Expense RVU 5.20, and Malpractice RVU 0.50. RVUs (Relative Value Units) determine Medicare reimbursement rates.

What documentation is required for CPT 99291?

Key documentation requirements for CPT 99291 include: High complexity medical decision making; Continuous monitoring documentation; Interventions and medications administered; Time spent and critical care procedures. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 99291 be billed with other codes?

Bundling considerations for CPT 99291: Includes all critical care evaluation and management. Includes interpretation of monitoring and labs Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 99291?

Common modifiers for CPT 99291 include: 25 (Separate E&M from procedure on same day), 59 (Distinct procedural service), 91 (Repeat clinical observation). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

What is the time requirement for CPT 99291?

The typical time requirement for CPT 99291 is First 30-74 minutes of critical care time. Time-based codes require documentation of the actual time spent providing the service.

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