99291

🎯 CPT Code 99291 Documentation & Billing Guide

Last Updated: February 2026
Status: 2025 Medicare Fee Schedule Compliant

---

CPT 99291 - Critical Care (First 30-74 min)

Description & Explanation: Evaluation and management of the critically ill or critically injured patient.

• Definition: Requires “high complexity decision making to assess, manipulate, and support vital system function(s) to treat single or multiple vital organ system failure and/or to prevent further life-threatening deterioration.”

• Time Based: This code covers the first 30 to 74 minutes of critical care time on a given date.

• Excludes: Procedures with “ZZZ” global periods are often bundled, but many distinct procedures (intubation, central line) are billable separately.

Code Tree:

• Evaluation and Management

  • Critical Care Services

    • 99291: Critical care, first 30-74 minutes

Technical Data:

• WRVU (2025): ~4.50

• Global Period: XXX

• Assistant Payable: No

Bundling & Edits:

• Exclusive: Cannot bill if total time is < 30 minutes (use appropriate E/M code instead).

• Included Services: Interpretation of cardiac output, CXR, blood gases, gastric intubation, temporary transcutaneous pacing, ventilator management, and vascular access procedures (peripheral).

• Bill Separately: Intubation (31500), Central Line (36556), CPR (92950).

Clinical Examples:

1. Septic Shock: 50 minutes spent managing a hypotensive patient, ordering fluids, starting Levophed, reviewing lactate/blood gases, and documenting reassessments.

2. Respiratory Failure: 45 minutes managing a patient with acute COPD exacerbation requiring BiPAP, frequent ABG checks, and continuous nebulizers.