99221
1st hosp ip/obs sf/low 40
Initial inpatient or observation E/M, selected using straightforward or low medical decision making or at least 40 minutes of qualifying total time on the encounter date.
Published by RVUDoc. Numeric data: CMS RVU26C, effective 2026-07-01. Page updated 2026-09-23. Calculation limits and editorial policy.
No national non-facility estimate is shown for this status or setting. This does not determine other payer coverage.
Billing guidance for 99221 is locked
- When to use it: the exact clinical situations that support billing 99221
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 4 mistakes that get 99221 downcoded or denied
Payer notes
Verify payer-specific coverage, practitioner rules and same-day service limits. Commercial payment is not necessarily the Medicare fee schedule. Related codes may be alternatives rather than services that can be reported together.
Related codes
These include alternative services and possible add-ons. Listing codes together does not establish that they can be billed together; check the applicable edits and payer policy.
See what 99221 adds to your year
Add it to the wRVU calculator with your own volume, or paste a note and let the chart audit check your coding.