99236
Hosp same-day adm/disch high 85 min
Hospital inpatient or observation care services for evaluation and management of a patient admitted and discharged on the same date, high-level medical decision making or 85 minutes total time. CMS 2026 wRVU 4.20.
When to use it
High-acuity same-day admit-and-discharge. Used when the patient required intensive management during the brief stay: emergent decompensation that resolved with treatment, decision regarding higher-level admission that was averted, or drug therapy requiring intensive monitoring during the stay.
Full guidance
Less common than 99234 or 99235; reserved for the genuinely high-MDM case.
Documentation checklist
- ✓MDM high complexity OR 85 minutes total time.
- ✓Document the high-risk element explicitly.
- ✓Document discharge readiness and post-discharge plan.
Common pitfalls
- !Up-coding from 99235 without a true high-complexity element.
- !Forgetting G0316 prolonged service if total time exceeded 100 minutes.
Payer notes
Medicare audits 99236 closely given the high allowable; expect post-payment review at panel-level 99236 rates above the specialty average.