99291
Critical care first hour
Critical care for a critically ill or injured patient; initial time-based service.
Published by RVUDoc. Numeric data: CMS RVU26D, effective 2026-10-01, checked 2026-10-03. Coding guidance reviewed 2026-09-23. Calculation limits and editorial policy.
Fee-schedule estimate before claim adjustments. Coverage, setting and payer rules still apply.
Billing guidance for 99291 is locked
- When to use it: the exact clinical situations that support billing 99291
- Documentation checklist: the 3 elements your note needs before submitting
- Common pitfalls: the 3 mistakes that get 99291 downcoded or denied
Payer notes
For Medicare, 99291 covers qualifying critical care before the first 99292 threshold at 104 total minutes. Same-group, concurrent, split/shared and global-surgery rules require additional review. Other payers may use different time rules.
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 99291 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.