E/M Est · CMS status A
99212
Office o/p est sf 10 min
Office or other outpatient visit, established patient, straightforward medical decision making OR 10 to 19 minutes of total time on the date of the encounter. CMS 2026 wRVU 0.70. Reserved for truly minor, single-problem encounters; most established-patient encounters meet 99213 or 99214 criteria.
Work RVU
0.70
2026 Medicare pays
$59.45
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 0.70 + Practice 1.02 + Malpractice 0.06 = 1.78 total
Work (your effort)Practice expenseMalpractice
Billing guidance for 99212 is locked
- When to use it: the exact clinical situations that support billing 99212
- Documentation checklist: the 4 elements your note needs before submitting
- Common pitfalls: the 4 mistakes that get 99212 downcoded or denied
Start your free 3-month trial →Every new account gets full Pro Max access for 3 months. No card needed.
Common modifiers
2595
Common ICD-10 pairings
I10J06.9Z79.01L70.0
Payer notes
Medicare and commercial payers cover 99212 routinely. The 99213-to-99212 ratio is sometimes audited; clinicians with high 99212 rates relative to peers may be flagged for under-coding (rare audit pattern, but real). Most clinicians find that careful 2021-guideline-aligned coding moves many 99212 encounters to 99213.
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.