CPT code 99291: Critical care, initial service, at least 30 minutes2026 Medicare rate & RVUs in Arkansas

Report 99291 when a physician or qualified health care professional spends at least 30 minutes managing a patient at high risk of imminent, life-threatening deterioration.

CMS RVU26DEffective Oct 1, 2026One payment locality5.8M Medicare services in 2024

In Arkansas, Medicare pays $281.30 for 99291 in the office and $186.91 when it’s performed in a hospital or facility.

$281.30Office (non-facility)
$186.91Hospital or facility
−9.0%vs the national office rate ($308.96)

Check a contract rate as a % of Medicare · 99291 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 99291 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Arkansas
  2. What 99291 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99291 covers

Critical care involves active management of an illness or injury that acutely threatens a vital organ system, with a high likelihood of imminent, life-threatening deterioration. Typical situations include septic shock requiring vasopressors and acute respiratory failure requiring ventilatory support. Emergency physicians, intensivists, hospitalists, and other physicians or qualified health care professionals furnish it in an ICU, emergency department, or another setting. The patient's condition and the care provided, not the location, establish whether the service qualifies.

Report 99291 after at least 30 minutes of qualifying critical care on the same date. Intervals need not be continuous, but overlapping practitioners' time cannot be counted twice. Document the critical condition, interventions, and total qualifying time. Count bedside care and directly related work on the unit, including necessary discussions with surrogates when the patient cannot participate. Exclude time spent on separately billable procedures, such as intubation or central venous catheter insertion. Chest radiograph and blood gas interpretation, pulse oximetry, ventilator management, gastric intubation, and peripheral vascular access are included in critical care. For Medicare, the first unit of 99292 requires 104 total minutes.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Arkansas compares for 99291

Across 109 of 109 payment localities, the office rate for 99291 runs from $281.30 in Arkansas to $386.53 in Alaska. Arkansas pays $281.30. The RVUs are the same everywhere; the geographic indexes change the dollars.

99291 in Arkansas vs other payment areas
  1. Arkansas · this page$281.30
  2. Los Angeles, CA · California$336.18+$54.88
  3. Washington, DC area · District of Columbia$344.32+$63.02
  4. Miami, FL · Florida$338.33+$57.03
  5. Chicago, IL · Illinois$330.62+$49.32
  6. Manhattan, NY · New York$350.79+$69.49
  7. Alaska · Alaska$386.53+$105.23

Other areas in Arkansas first, then benchmark localities. Bars start at $0.

Every other payment area

99291 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$284.38$188.23
ArizonaArizona$302.30$195.82
Bakersfield, CACalifornia$319.56$199.12
Chico, CACalifornia$318.14$197.70
El Centro, CACalifornia$318.22$197.78
Fresno, CACalifornia$318.14$197.70
Hanford, CACalifornia$318.14$197.70
Madera, CACalifornia$318.14$197.70

99291 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$281.30

$386.53

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99291 office rate range by state
State / territoryOffice rate rangeLocalities
AK$386.531
AL$284.381
AR$281.301
AZ$302.301
CA$318.14–$381.7029
CO$316.571
CT$326.221
DC$344.321
DE$306.441
FL$310.38–$338.333
GA$296.43–$314.792
GU$322.121
HI$322.121
IA$287.511
ID$289.401
IL$305.14–$330.624
IN$290.601
KS$287.581
KY$291.751
LA$291.83–$302.592
MA$315.84–$341.232
MD$310.92–$344.323
ME$291.69–$302.002
MI$298.47–$314.482
MN$302.301
MO$288.78–$302.113
MS$285.031
MT$308.931
NC$293.811
ND$299.831
NE$288.371
NH$312.911
NJ$329.64–$342.402
NM$300.151
NV$306.541
NY$297.23–$358.835
OH$296.621
OK$290.201
OR$303.82–$323.342
PA$296.36–$320.502
PR$310.301
RI$314.881
SC$295.761
SD$298.761
TN$288.811
TX$294.97–$315.828
UT$298.791
VA$302.01–$344.322
VI$310.301
VT$299.941
WA$314.83–$346.192
WI$292.311
WV$296.811
WY$304.961

See 99291 in every payment locality

How the 99291 rate is calculated

Each of 99291’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99291

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.50

4.50 RVUs× 1.000 GPCI

Practice expense4.29

4.29 RVUs× 1.000 GPCI

Malpractice0.46

0.46 RVUs× 1.000 GPCI

Adjusted RVUs

9.2500

Conversion factor

$33.4009

Medicare rate

$308.96

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Arkansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,043

Code
99291
Physician work
4.50
Practice expense
4.29
Malpractice
0.46

GPCI2026.csv

7

Locality
Arkansas
Physician work
1.000
Practice expense
0.859
Malpractice
0.515
Office calculation for 99291 in Arkansas
ComponentRVULocality factorAdjusted
Physician work4.50× 1.0004.5000
Practice expense4.29× 0.8593.6851
Malpractice0.46× 0.5150.2369
Total RVUs8.4220
Conversion factor× 33.4009

Office rate, Arkansas$281.30

Office: (4.5 × 1 + 4.29 × 0.859 + 0.46 × 0.515) × $33.4009 = $281.30

Facility: (4.5 × 1 + 1 × 0.859 + 0.46 × 0.515) × $33.4009 = $186.91

Open 99291 in the RVU calculator

Payment rules and modifiers for 99291

99291 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99291

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$308.96

Non-facility (office)
$308.96
Facility
$199.07

Higher because the practice carries its own overhead.

How 99291 has changed in Arkansas

99291 · Office / nonfacility

$281.30

Effective 2026-10-01

The base rate is $37.40 higher than on 2025-10-01, moving from $243.90 to $281.30 (15.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $243.90changed to$281.30

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 3.27 changed to 4.29
    • Malpractice RVU 0.44 changed to 0.46
    • Practice expense GPCI 0.860 changed to 0.859
    • Malpractice GPCI 0.518 changed to 0.515

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $250.36changed to$243.90

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.26 changed to 3.27
    • Malpractice RVU 0.42 changed to 0.44

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $246.27changed to$250.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $252.28changed to$246.27

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.21 changed to 3.26
    • Practice expense GPCI 0.853 changed to 0.860
    • Malpractice GPCI 0.492 changed to 0.518
  5. January 1, 2023

    RVU23A

    $257.59changed to$252.28

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.25 changed to 3.21
    • Malpractice RVU 0.41 changed to 0.42
    • Practice expense GPCI 0.847 changed to 0.853
    • Malpractice GPCI 0.465 changed to 0.492

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $258.25changed to$257.59

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.20 changed to 3.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $262.62changed to$258.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.99 changed to 3.20
    • Malpractice RVU 0.40 changed to 0.41
    • Practice expense GPCI 0.859 changed to 0.847
    • Malpractice GPCI 0.521 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $262.35changed to$262.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.93 changed to 2.99
    • Malpractice RVU 0.39 changed to 0.40
    • Practice expense GPCI 0.872 changed to 0.859
    • Malpractice GPCI 0.576 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $260.29changed to$262.35

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.88 changed to 2.93
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $258.57changed to$260.29

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.86 changed to 2.88
    • Malpractice RVU 0.39 changed to 0.38
    • Practice expense GPCI 0.870 changed to 0.872
    • Malpractice GPCI 0.555 changed to 0.576

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $257.36changed to$258.57

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.867 changed to 0.870
    • Malpractice GPCI 0.534 changed to 0.555

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $258.79changed to$257.36

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.87 changed to 2.86
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $257.50changed to$258.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $255.12changed to$257.50

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.84 changed to 2.87
    • Malpractice RVU 0.33 changed to 0.40
    • Practice expense GPCI 0.866 changed to 0.867
    • Malpractice GPCI 0.492 changed to 0.534

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $251.31changed to$255.12

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.16 changed to 2.84
    • Malpractice RVU 0.34 changed to 0.33
    • Practice expense GPCI 0.865 changed to 0.866
    • Malpractice GPCI 0.450 changed to 0.492

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $251.31

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$281.30$186.91RVU26D
2026-07-01$281.30$186.91RVU26C
2026-04-01$281.30$186.91RVU26B
2026-01-01$281.30$186.91RVU26A
2025-10-01$243.90$192.43RVU25D
2025-07-01$243.90$192.43RVU25C
2025-04-01$243.90$192.43RVU25B
2025-01-01$243.90$192.43RVU25A
2024-10-01$250.36$196.83RVU24D
2024-07-01$250.36$196.83RVU24C
2024-04-01$250.36$196.83RVU24B
2024-03-09$250.36$196.83RVU24AR
2024-01-01$246.27$193.62RVU24A
2023-10-01$252.28$199.67RVU23D
2023-07-01$252.28$199.67RVU23C
2023-04-01$252.28$199.67RVU23B
2023-01-01$252.28$199.67RVU23A
2022-10-01$257.59$203.95RVU22D
2022-07-01$257.59$203.95RVU22C
2022-04-01$257.59$203.95RVU22B
2022-01-01$257.59$203.95RVU22A
2021-10-01$258.25$205.64RVU21D
2021-07-01$258.25$205.64RVU21C
2021-04-01$258.25$205.64RVU21B
2021-01-01$258.25$205.64RVU21A
2020-10-01$262.62$212.71RVU20D
2020-07-01$262.62$212.71RVU20C
2020-04-01$262.62$212.71RVU20B
2020-01-01$262.62$212.71RVU20A
2019-10-01$262.35$213.95RVU19D
2019-07-01$262.35$213.95RVU19C
2019-04-01$262.35$213.95RVU19B
2019-01-01$262.35$213.95RVU19A
2018-10-01$260.29$214.45RVU18D
2018-07-01$260.29$214.45RVU18C
2018-04-01$260.29$214.45RVU18B
2018-01-01$260.29$214.45RVU18AR1
2017-10-01$258.57$213.92RVU17D
2017-07-01$258.57$213.92RVU17C
2017-04-01$258.57$213.92RVU17B
2017-01-01$258.57$213.92RVU17A
2016-10-01$257.36$212.66RVU16D
2016-07-01$257.36$212.66RVU16C
2016-04-01$257.36$212.66RVU16B
2016-01-01$257.36$212.66RVU16A
2015-10-01$258.79$213.93RVU15D
2015-07-01$258.79$213.93RVU15C
2015-04-01$257.50$212.86RVU15B
2015-01-01$257.50$212.86RVU15A
2014-10-01$255.12$211.69RVU14D
2014-07-01$255.12$211.69RVU14C
2014-04-01$255.12$211.69RVU14B
2014-01-01$255.12$211.69RVU14A
2013-10-01$251.31$204.22RVU13D
2013-07-01$251.31$204.22RVU13C
2013-04-01$251.31$204.22RVU13B
2013-01-01$251.31$204.22RVU13AR

Price 99291 for an earlier date of service

Where the Arkansas rate applies

Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.

  • Acorn
  • Adona
  • Alexander
  • Alicia
  • Alix
  • Alleene
  • Allport
  • Alma

Browse all communities in Arkansas

99291 billing questions

When does Medicare allow 99292 to be added to 99291?

Medicare requires at least 104 total minutes of critical care for the first unit of 99292. CPT reporting starts the add-on at 75 minutes, so the threshold differs.

Can an ED visit and critical care be billed the same day?

Medicare allows both when a medically necessary, separately identifiable ED visit occurred before the patient's condition became critical. Append modifier 25 to the ED visit and document the change in condition.

Which procedures can be billed separately with 99291?

Endotracheal intubation, CPR, central venous catheter placement, arterial line placement, and cardioversion may be separately reported when performed. Exclude the time spent on each separately reported procedure from critical care time.

How is split or shared critical care reported?

When a physician and an NP or PA in the same group furnish critical care, add their nonoverlapping qualifying time. The practitioner who furnished more than half the total time reports the service with modifier FS.

Can two physicians bill critical care for the same patient on the same date?

Physicians of different specialties may each report medically necessary, nonduplicative critical care. Physicians of the same specialty in the same group are treated as one for reporting purposes, and their nonoverlapping time is combined.

Does an ICU admission automatically qualify for 99291?

No. Documentation must support an acute threat to a vital organ system, a high likelihood of imminent, life-threatening deterioration, the critical care provided, and at least 30 minutes of qualifying time.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99291PPRRVU2026_Oct_nonQPP.csv, line 13,043 (RVU26D)
Geographic factors for ArkansasGPCI2026.csv, line 7 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 99291 pays in Arkansas?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 99291 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist