99223
1st hosp ip/obs high 75
Initial hospital inpatient or observation care, selected by high medical decision making or at least 75 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 99223 is locked
- When to use it: the exact clinical situations that support billing 99223
- Documentation checklist: the 4 elements your note needs before submitting
- Common pitfalls: the 3 mistakes that get 99223 downcoded or denied
Payer notes
For Medicare prolonged services with time-selected 99223, the first G0316 unit requires 90 minutes. CPT 99418 may apply for payers recognizing it; 99357 was deleted.
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 99223 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.