{
    "code": "99291",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99291/2015/A",
    "release_specific_url": "https://localishealth.com/cpt/99291/2015/B",
    "description": "Direct, intensive physician care of a patient whose illness or injury is acutely impairing one or more vital organ systems, with a real chance of rapid deterioration — septic shock, respiratory failure, major trauma, a severe overdose. It demands high-complexity decision making and the physician's full attention devoted to that one patient, to the exclusion of everyone else. This code covers the first block of critical care time in a day, running from half an hour up to about an hour and a quarter; a shorter encounter is reported as an ordinary visit instead, and longer ones bring in a companion add-on code. The time counted includes work at the bedside and time spent elsewhere on the unit devoted solely to that patient, such as reviewing test results or talking with family about treatment decisions.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99291 in Q2 2015?",
        "text": "Medicare paid $277.81 for CPT 99291 in the office (non-facility) setting and $226.33 in a facility under the Q2 2015 Physician Fee Schedule, effective April 2015. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2015, when it increased 1.1%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2015,
        "quarter": "B",
        "label": "Q2 2015",
        "effective": "April 1 – June 30, 2015",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 277.81,
        "facility": 226.33,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 4.5,
        "practice_expense_non_facility": 2.87,
        "practice_expense_facility": 1.43,
        "malpractice": 0.4
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.7547,
    "source": {
        "label": "Physician relative value file (Q2 2015)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu15b.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2015/B",
        "file": "PPRRVU15_V0213_Current.csv",
        "row": 15963,
        "sha256": "61c24302bb17747bddd4aa44ef136d9628930f35dd595e299d9a5370bd394705"
    },
    "modified_at": "2026-08-04T03:05:48+00:00"
}