{
    "code": "99212",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99212/2020/A",
    "release_specific_url": "https://localishealth.com/cpt/99212/2020/D",
    "description": "A short established-patient visit for a single, straightforward problem — for example, a routine medication refill check or a minor, self-limited issue like a mild rash. Total visit time typically runs about 10 to 19 minutes, and documentation needs to show one uncomplicated problem, minimal or no data reviewed, and low risk from the plan of care.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99212 in Q4 2020?",
        "text": "Medicare paid $46.19 for CPT 99212 in the office (non-facility) setting and $26.35 in a facility under the Q4 2020 Physician Fee Schedule, effective October 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2020, when it increased 0.9%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2020,
        "quarter": "D",
        "label": "Q4 2020",
        "effective": "October 1 – December 31, 2020",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 46.19,
        "facility": 26.35,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.48,
        "practice_expense_non_facility": 0.75,
        "practice_expense_facility": 0.2,
        "malpractice": 0.05
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0896,
    "source": {
        "label": "Physician relative value file (Q4 2020)",
        "cms_url": "https://www.cms.gov/files/zip/rvu20d-updated-11232020.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2020/D",
        "file": "PPRRVU20_OCT.csv",
        "row": 17171,
        "sha256": "504fd19a9bc1d2eeebb290adac2d7de6c56d4e86cde7532df1862fe42494d319"
    },
    "modified_at": "2026-08-04T03:10:00+00:00"
}