CPT code 99422: Online E/M, established patient, 11–20 minutes2026 Medicare rate & RVUs in Nevada

Reports an established-patient online evaluation and management service when the physician or qualified health professional spends 11–20 cumulative minutes managing the request over seven days.

CMS RVU26DEffective Oct 1, 2026One payment locality40.9K Medicare services in 2024

In Nevada, Medicare pays $30.52 for 99422 in the office and $22.16 when it’s performed in a hospital or facility.

$30.52Office (non-facility)
$22.16Hospital or facility
−0.7%vs the national office rate ($30.73)

Check a contract rate as a % of Medicare · 99422 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 99422 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 99422 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 99422 covers

This code covers a patient-initiated, asynchronous evaluation and management service handled through a secure online channel, such as a patient portal. A physician or other qualified health professional reviews the patient’s request and relevant record, evaluates the issue, and responds with management advice or orders as appropriate. It is used for established patients whose concern can be addressed without a real-time office, phone, or video visit.

Report the code once for the physician’s or qualified health professional’s cumulative service time of 11–20 minutes during the seven-day period. Time may include reviewing the request and record, assessment and management, and communicating the response; clinical staff time is not the provider time counted for this service. Keep the patient’s request, clinical assessment, response, dates, and time accounting in the record. The service is not separately reported when it arises from a related E/M service in the preceding seven days or leads to an E/M service within 24 hours or the soonest available appointment; in those circumstances, its work is part of that service.

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 Nevada compares for 99422

Across 109 of 109 payment localities, the office rate for 99422 runs from $28.29 in Arkansas to $39.30 in Alaska. Nevada pays $30.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

99422 in Nevada vs other payment areas
  1. Nevada · this page$30.52
  2. Los Angeles, CA · California$33.29+$2.77
  3. Washington, DC area · District of Columbia$34.04+$3.52
  4. Miami, FL · Florida$33.29+$2.77
  5. Chicago, IL · Illinois$32.64+$2.12
  6. Manhattan, NY · New York$34.64+$4.12
  7. Alaska · Alaska$39.30+$8.78

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

Every other payment area

99422 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$28.56$21.26
ArkansasArkansas$28.29$21.12
ArizonaArizona$30.14$22.05
Bakersfield, CACalifornia$31.74$22.59
Chico, CACalifornia$31.61$22.46
El Centro, CACalifornia$31.62$22.47
Fresno, CACalifornia$31.61$22.46
Hanford, CACalifornia$31.61$22.46

99422 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.

$28.29

$39.30

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

View every state and territory as a table
99422 office rate range by state
State / territoryOffice rate rangeLocalities
AK$39.301
AL$28.561
AR$28.291
AZ$30.141
CA$31.61–$37.5629
CO$31.451
CT$32.321
DC$34.041
DE$30.531
FL$30.84–$33.293
GA$29.61–$31.252
GU$31.911
HI$31.911
IA$28.841
ID$29.011
IL$30.38–$32.644
IN$29.121
KS$28.851
KY$29.211
LA$29.21–$30.162
MA$31.40–$33.732
MD$30.94–$34.043
ME$29.21–$30.122
MI$29.80–$31.202
MN$30.161
MO$28.94–$30.123
MS$28.621
MT$30.731
NC$29.401
ND$29.941
NE$28.921
NH$31.081
NJ$32.69–$33.902
NM$29.941
NV$30.521
NY$29.70–$35.345
OH$29.641
OK$29.071
OR$30.28–$32.062
PA$29.61–$31.812
PR$30.851
RI$31.321
SC$29.561
SD$29.841
TN$28.961
TX$29.49–$31.358
UT$29.831
VA$30.12–$34.042
VI$30.851
VT$29.941
WA$31.30–$34.202
WI$29.271
WV$29.641
WY$30.381

See 99422 in every payment locality

How the 99422 rate is calculated

Each of 99422’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 · 99422

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.50

0.50 RVUs× 1.000 GPCI

Practice expense0.38

0.38 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

0.9200

Conversion factor

$33.4009

Medicare rate

$30.73

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

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,103

Code
99422
Physician work
0.50
Practice expense
0.38
Malpractice
0.04

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 99422 in Nevada
ComponentRVULocality factorAdjusted
Physician work0.50× 1.0000.5000
Practice expense0.38× 1.0010.3804
Malpractice0.04× 0.8330.0333
Total RVUs0.9137
Conversion factor× 33.4009

Office rate, Nevada$30.52

Office: (0.5 × 1 + 0.38 × 1.001 + 0.04 × 0.833) × $33.4009 = $30.52

Facility: (0.5 × 1 + 0.13 × 1.001 + 0.04 × 0.833) × $33.4009 = $22.16

Open 99422 in the RVU calculator

Payment rules and modifiers for 99422

99422 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 · 99422

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$30.73

Non-facility (office)
$30.73
Facility
$22.38

Higher because the practice carries its own overhead.

How 99422 has changed in Nevada

99422 · Office / nonfacility

$30.52

Effective 2026-10-01

The base rate is $2.26 higher than on 2025-10-01, moving from $28.26 to $30.52 (8.0%).

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

    $28.26changed to$30.52

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.34 changed to 0.38
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $29.09changed to$28.26

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $28.61changed to$29.09

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $29.61changed to$28.61

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.33 changed to 0.34
    • Malpractice GPCI 1.098 changed to 0.844
  5. January 1, 2023

    RVU23A

    $30.33changed to$29.61

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.32 changed to 0.33
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $30.59changed to$30.33

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $31.34changed to$30.59

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.31 changed to 0.32
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    No ratechanged to$31.34

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$30.52$22.16RVU26D
2026-07-01$30.52$22.16RVU26C
2026-04-01$30.52$22.16RVU26B
2026-01-01$30.52$22.16RVU26A
2025-10-01$28.26$24.38RVU25D
2025-07-01$28.26$24.38RVU25C
2025-04-01$28.26$24.38RVU25B
2025-01-01$28.26$24.38RVU25A
2024-10-01$29.09$24.76RVU24D
2024-07-01$29.09$24.76RVU24C
2024-04-01$29.09$24.76RVU24B
2024-03-09$29.09$24.76RVU24AR
2024-01-01$28.61$24.35RVU24A
2023-10-01$29.61$25.55RVU23D
2023-07-01$29.61$25.55RVU23C
2023-04-01$29.61$25.55RVU23B
2023-01-01$29.61$25.55RVU23A
2022-10-01$30.33$26.53RVU22D
2022-07-01$30.33$26.53RVU22C
2022-04-01$30.33$26.53RVU22B
2022-01-01$30.33$26.53RVU22A
2021-10-01$30.59$26.75RVU21D
2021-07-01$30.59$26.75RVU21C
2021-04-01$30.59$26.75RVU21B
2021-01-01$30.59$26.75RVU21A
2020-10-01$31.34$27.73RVU20D
2020-07-01$31.34$27.73RVU20C
2020-04-01$31.34$27.73RVU20B
2020-01-01$31.34$27.73RVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 99422 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

99422 billing questions

How is 99422 different from 99421 or 99423?

The distinction is the physician’s or qualified health professional’s cumulative time over the seven-day period: 99422 covers 11–20 minutes. Use 99421 for the lower time tier and 99423 for the higher tier.

Can multiple portal messages be counted together?

Yes. Count the provider’s eligible work across the seven-day period and report one code at the tier supported by the cumulative time, rather than billing each message separately.

Does staff time count toward 99422?

No. The time threshold is based on the physician’s or other qualified health professional’s work; staff handling or routing the portal message does not establish the provider time.

What documentation supports the service?

Document the patient’s online request, the issue evaluated, the provider’s assessment and response, and the dates and cumulative provider time supporting the 11–20-minute tier.

Can 99422 be reported when the patient has an office visit shortly afterward?

If the online work leads to an E/M service within 24 hours or the soonest available appointment, it is included in that service rather than separately reported as 99422.

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 99422PPRRVU2026_Oct_nonQPP.csv, line 13,103 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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