# CPT 99214

> Medicare paid $131.20 for CPT 99214 in the office (non-facility) setting and $100.49 in a facility under the Q1 2021 Physician Fee Schedule, effective January 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 18.8% increase from the previous quarter.

## What it is

A more involved established-patient visit — for example, managing multiple chronic conditions that are not fully controlled (such as diabetes needing a medication change), or a new problem with an uncertain diagnosis that requires prescription drug management. Total visit time typically runs about 30 to 39 minutes. Documentation needs to support a higher level of decision-making: more than one chronic illness with exacerbation, or moderate risk from the treatment plan, such as starting or adjusting a prescription drug.

## Selected release

- Release: Q1 2021 (2021 A)
- Effective: January 1 – March 31, 2021
- Status indicator: A
- Office (non-facility) national allowed amount: $131.20
- Facility national allowed amount: $100.49
- Sequestration: not applied

## RVUs and formula

- Work RVU: 1.92
- Office (non-facility) practice expense RVU: 1.70
- Facility practice expense RVU: 0.82
- Malpractice RVU: 0.14
- Conversion factor: 34.8931
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q1 2021)
- CMS file: https://www.cms.gov/files/zip/rvu21a-updated-01052021.zip
- Parsed file: PPRRVU21_JAN.csv, row 17,152
- Canonical page: https://localishealth.com/cpt/99214/2021/A
- Release-specific citation URL: https://localishealth.com/cpt/99214/2021/A
- Last significant update: 2026-08-04T03:10:16+00:00