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CMS RVU26D · Effective 2026-10-01

99211 in Austin

Office / nonfacility

$25.40

Base rate per service

Facility setting

$7.73

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Evaluation and management

About 99211: Established patient minimal office E/M visit

Report a minimal office or outpatient E/M visit for an established patient when a distinct service is provided, often by clinical staff under supervision.

This is the lowest-level established-patient office or outpatient E/M visit. A physician or other qualified health care professional may not need to be present for the encounter. An RN, LPN, or medical assistant may recheck blood pressure against an existing treatment plan or teach a patient how to use a prescribed device. A physician or qualified practitioner may also perform a visit at this level. The encounter must involve a medically necessary evaluation or management service, rather than a measurement taken solely as part of another service.

Select 99211 without using the medical decision-making levels or minimum practitioner times used for 99212 through 99215. Document the reason for the encounter, relevant findings, assessment or instructions, and, for a staff visit, its connection to the treating practitioner's plan. For Medicare office billing of clinical-staff services incident to a practitioner’s work, the practitioner must have initiated treatment and provide required direct supervision, including being present in the office suite and immediately available. If the encounter consists only of an injection or specimen draw, report the applicable procedure rather than an additional 99211.

Where the value comes from

  • Work RVU0.18 · 25%
  • Practice expense (office) RVU0.54 · 74%
  • Malpractice RVU0.01 · 1%

1.3M

Medicare services in 2024 · #123 by national volume

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.

99211 compared with similar codes

Office rates for Austin, from the same CMS release.

99212

Office visit

Established patient, straightforward

$61.25

99212 requires a physician or qualified practitioner's E/M service supported by straightforward MDM or at least 10 minutes of practitioner time. Clinical staff can provide a qualifying 99211 service under applicable supervision requirements.

96372

SC/IM injection

Therapeutic, prophylactic, or diagnostic

$15.88

If the encounter consists only of a therapeutic injection, report the administration service, not 99211. A distinct, medically necessary E/M service must be documented to consider reporting 99211 as well.

36415

Coll venous bld venipuncture

No office rate

Report a visit solely for routine venipuncture with the applicable collection code. Do not add 99211 merely because the patient came to the office for a blood draw.

99202

New patient visit

Straightforward MDM or 15 minutes

$77.37

99202 is a practitioner E/M visit for a new patient, selected by straightforward MDM or at least 15 minutes of practitioner time. 99211 is limited to established patients and may be performed by clinical staff.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 99211 is $22.74—$2.66 lower than the $25.40 rate in Austin. Both use the same code, release and participation basis.

99211 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $25.40

  2. Beaumont

    $22.74

    $2.66 lower than Austin

  3. Brazoria

    $24.19

    $1.21 lower than Austin

  4. Dallas

    $24.32

    $1.08 lower than Austin

  5. Fort Worth

    $24.14

    $1.26 lower than Austin

  6. Galveston

    $24.25

    $1.15 lower than Austin

  7. Houston

    $24.43

    $0.97 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 99211 ranges from $21.68 in Arkansas to $32.86 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 99211

    Office

    $23.43

    Facility

    $7.58

    $1.97 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 99211

    Office

    $27.82

    Facility

    $8.06

    $2.42 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 99211

    Office

    $27.96

    Facility

    $8.28

    $2.56 higher than Austin for the office setting.

  • Miami

    Florida · 99211

    Office

    $25.63

    Facility

    $8.25

    $0.23 higher than Austin for the office setting.

  • Chicago

    Illinois · 99211

    Office

    $24.95

    Facility

    $8.16

    $0.45 lower than Austin for the office setting.

  • Manhattan

    New York · 99211

    Office

    $27.89

    Facility

    $8.48

    $2.49 higher than Austin for the office setting.

  • Alaska*

    Alaska · 99211

    Office

    $28.41

    Facility

    $10.63

    $3.01 higher than Austin for the office setting.

  • Alabama

    Alabama · 99211

    Office

    $21.98

    Facility

    $7.37

    $3.42 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 99211

    Office

    $21.68

    Facility

    $7.33

    $3.72 lower than Austin for the office setting.

  • Arizona

    Arizona · 99211

    Office

    $23.78

    Facility

    $7.59

    $1.62 lower than Austin for the office setting.

  • Bakersfield

    California · 99211

    Office

    $26.10

    Facility

    $7.79

    $0.70 higher than Austin for the office setting.

  • Chico

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • El Centro

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Fresno

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Madera

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Merced

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Modesto

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Napa

    California · 99211

    Office

    $30.33

    Facility

    $8.32

    $4.93 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99211

    Office

    $27.71

    Facility

    $7.97

    $2.31 higher than Austin for the office setting.

  • Redding

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Rest Of California

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99211

    Office

    $26.17

    Facility

    $7.87

    $0.77 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99211

    Office

    $27.38

    Facility

    $7.96

    $1.98 higher than Austin for the office setting.

  • Salinas

    California · 99211

    Office

    $27.28

    Facility

    $7.93

    $1.88 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99211

    Office

    $27.95

    Facility

    $7.97

    $2.55 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99211

    Office

    $32.17

    Facility

    $8.62

    $6.77 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 99211

    Office

    $32.16

    Facility

    $8.61

    $6.76 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 99211

    Office

    $32.86

    Facility

    $8.78

    $7.46 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 99211

    Office

    $32.81

    Facility

    $8.73

    $7.41 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99211

    Office

    $26.84

    Facility

    $7.82

    $1.44 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 99211

    Office

    $28.23

    Facility

    $7.94

    $2.83 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 99211

    Office

    $27.39

    Facility

    $7.92

    $1.99 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 99211

    Office

    $28.52

    Facility

    $8.01

    $3.12 higher than Austin for the office setting.

  • Stockton

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Vallejo

    California · 99211

    Office

    $30.32

    Facility

    $8.31

    $4.92 higher than Austin for the office setting.

  • Visalia

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Yuba City

    California · 99211

    Office

    $26.06

    Facility

    $7.76

    $0.66 higher than Austin for the office setting.

  • Colorado

    Colorado · 99211

    Office

    $25.54

    Facility

    $7.77

    $0.14 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 99211

    Office

    $25.96

    Facility

    $7.98

    $0.56 higher than Austin for the office setting.

  • Delaware

    Delaware · 99211

    Office

    $24.16

    Facility

    $7.66

    $1.24 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 99211

    Office

    $24.89

    Facility

    $7.97

    $0.51 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 99211

    Office

    $23.76

    Facility

    $7.79

    $1.64 lower than Austin for the office setting.

  • Atlanta

    Georgia · 99211

    Office

    $24.76

    Facility

    $7.79

    $0.64 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 99211

    Office

    $22.50

    Facility

    $7.60

    $2.90 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 99211

    Office

    $26.71

    Facility

    $7.72

    $1.31 higher than Austin for the office setting.

  • Iowa

    Iowa · 99211

    Office

    $22.65

    Facility

    $7.37

    $2.75 lower than Austin for the office setting.

  • Idaho

    Idaho · 99211

    Office

    $22.76

    Facility

    $7.40

    $2.64 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 99211

    Office

    $23.28

    Facility

    $7.91

    $2.12 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 99211

    Office

    $23.00

    Facility

    $7.75

    $2.40 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 99211

    Office

    $25.17

    Facility

    $8.02

    $0.23 lower than Austin for the office setting.

  • Indiana

    Indiana · 99211

    Office

    $22.89

    Facility

    $7.41

    $2.51 lower than Austin for the office setting.

  • Kansas

    Kansas · 99211

    Office

    $22.49

    Facility

    $7.39

    $2.91 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 99211

    Office

    $22.35

    Facility

    $7.51

    $3.05 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 99211

    Office

    $23.36

    Facility

    $7.65

    $2.04 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 99211

    Office

    $22.29

    Facility

    $7.51

    $3.11 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 99211

    Office

    $28.09

    Facility

    $8.15

    $2.69 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99211

    Office

    $25.37

    Facility

    $7.78

    $0.03 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99211

    Office

    $25.87

    Facility

    $7.96

    $0.47 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 99211

    Office

    $24.63

    Facility

    $7.73

    $0.77 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 99211

    Office

    $22.81

    Facility

    $7.45

    $2.59 lower than Austin for the office setting.

  • Southern Maine

    Maine · 99211

    Office

    $24.10

    Facility

    $7.55

    $1.30 lower than Austin for the office setting.

  • Detroit

    Michigan · 99211

    Office

    $23.98

    Facility

    $7.86

    $1.42 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 99211

    Office

    $22.86

    Facility

    $7.61

    $2.54 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 99211

    Office

    $24.67

    Facility

    $7.49

    $0.73 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 99211

    Office

    $23.27

    Facility

    $7.59

    $2.13 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 99211

    Office

    $23.52

    Facility

    $7.62

    $1.88 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 99211

    Office

    $21.88

    Facility

    $7.49

    $3.52 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 99211

    Office

    $21.79

    Facility

    $7.41

    $3.61 lower than Austin for the office setting.

  • Montana**

    Montana · 99211

    Office

    $24.38

    Facility

    $7.68

    $1.02 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 99211

    Office

    $23.05

    Facility

    $7.47

    $2.35 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 99211

    Office

    $24.18

    Facility

    $7.48

    $1.22 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 99211

    Office

    $22.79

    Facility

    $7.37

    $2.61 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 99211

    Office

    $25.08

    Facility

    $7.70

    $0.32 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 99211

    Office

    $27.67

    Facility

    $8.30

    $2.27 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 99211

    Office

    $26.31

    Facility

    $8.08

    $0.91 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 99211

    Office

    $22.95

    Facility

    $7.64

    $2.45 lower than Austin for the office setting.

  • Nevada**

    Nevada · 99211

    Office

    $24.34

    Facility

    $7.63

    $1.06 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99211

    Office

    $28.46

    Facility

    $8.61

    $3.06 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99211

    Office

    $26.44

    Facility

    $8.15

    $1.04 higher than Austin for the office setting.

  • Queens

    New York · 99211

    Office

    $28.20

    Facility

    $8.46

    $2.80 higher than Austin for the office setting.

  • Rest Of New York

    New York · 99211

    Office

    $23.38

    Facility

    $7.52

    $2.02 lower than Austin for the office setting.

  • Ohio

    Ohio · 99211

    Office

    $22.82

    Facility

    $7.57

    $2.58 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 99211

    Office

    $22.38

    Facility

    $7.46

    $3.02 lower than Austin for the office setting.

  • Portland

    Oregon · 99211

    Office

    $26.40

    Facility

    $7.84

    $1.00 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 99211

    Office

    $24.21

    Facility

    $7.58

    $1.19 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99211

    Office

    $25.29

    Facility

    $7.91

    $0.11 lower than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99211

    Office

    $22.89

    Facility

    $7.55

    $2.51 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 99211

    Office

    $24.58

    Facility

    $7.69

    $0.82 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 99211

    Office

    $25.06

    Facility

    $7.80

    $0.34 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 99211

    Office

    $22.96

    Facility

    $7.53

    $2.44 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 99211

    Office

    $24.16

    Facility

    $7.46

    $1.24 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 99211

    Office

    $22.59

    Facility

    $7.41

    $2.81 lower than Austin for the office setting.

  • Utah

    Utah · 99211

    Office

    $23.27

    Facility

    $7.57

    $2.13 lower than Austin for the office setting.

  • Virginia

    Virginia · 99211

    Office

    $23.98

    Facility

    $7.56

    $1.42 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99211

    Office

    $24.58

    Facility

    $7.69

    $0.82 lower than Austin for the office setting.

  • Vermont

    Vermont · 99211

    Office

    $24.04

    Facility

    $7.50

    $1.36 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 99211

    Office

    $25.34

    Facility

    $7.75

    $0.06 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 99211

    Office

    $28.72

    Facility

    $8.22

    $3.32 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 99211

    Office

    $23.39

    Facility

    $7.39

    $2.01 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 99211

    Office

    $22.16

    Facility

    $7.65

    $3.24 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 99211

    Office

    $24.30

    Facility

    $7.60

    $1.10 lower than Austin for the office setting.

See how rates vary across the country

99211 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$21.68

$29.46

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$28.411
AL$21.981
AR$21.681
AZ$23.781
CA$26.06–$32.8629
CO$25.541
CT$25.961
DC$27.961
DE$24.161
FL$23.76–$25.633
GA$22.50–$24.762
GU$26.711
HI$26.711
IA$22.651
ID$22.761
IL$23.00–$25.174
IN$22.891
KS$22.491
KY$22.351
LA$22.29–$23.362
MA$25.37–$28.092
MD$24.63–$27.963
ME$22.81–$24.102
MI$22.86–$23.982
MN$24.671
MO$21.88–$23.523
MS$21.791
MT$24.381
NC$23.051
ND$24.181
NE$22.791
NH$25.081
NJ$26.31–$27.672
NM$22.951
NV$24.341
NY$23.38–$28.465
OH$22.821
OK$22.381
OR$24.21–$26.402
PA$22.89–$25.292
PR$24.581
RI$25.061
SC$22.961
SD$24.161
TN$22.591
TX$22.74–$25.408
UT$23.271
VA$23.98–$27.962
VI$24.581
VT$24.041
WA$25.34–$28.722
WI$23.391
WV$22.161
WY$24.301

Explore 99211 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 99211 in Austin, the physician’s office rate is $25.40 and the facility-setting rate is $7.73: a difference of $17.67.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 99211 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$27.94

$25.40 × 110% = $27.94

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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Primary care

Compare office and outpatient evaluation-and-management base rates.

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99211 in Austin.

PPRRVU2026_Oct_nonQPP.csv

13,013

Code
99211
Physician work
0.18
Practice expense
0.54
Malpractice
0.01

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 99211 in Austin
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0020.1804
Practice expense0.54× 1.0580.5713
Malpractice0.01× 0.8860.0089
Total RVUs0.7605
Conversion factor× 33.4009

Office / nonfacility rate, Austin$25.40

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 99211 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.181.002
Practice expense0.541.058
Malpractice0.010.886

(0.18 × 1.002 + 0.54 × 1.058 + 0.01 × 0.886) × $33.4009 = $25.40

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.181.002
Practice expense0.041.058
Malpractice0.010.886

(0.18 × 1.002 + 0.04 × 1.058 + 0.01 × 0.886) × $33.4009 = $7.73

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

99211 · Office / nonfacility

$25.40

Effective 2026-10-01

The base rate is $2.03 higher than on 2025-10-01, moving from $23.37 to $25.40 (8.7%).

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

    $23.37changed to$25.40

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.51 changed to 0.54
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $23.37

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$25.40$7.73RVU26D
2026-07-01$25.40$7.73RVU26C
2026-04-01$25.40$7.73RVU26B
2026-01-01$25.40$7.73RVU26A
2025-10-01$23.37$8.49RVU25D
2025-07-01$23.37$8.49RVU25C
2025-04-01$23.37$8.49RVU25B
2025-01-01$23.37$8.49RVU25A

99211 billing questions

Can a new patient visit be reported with 99211?

No. 99211 is limited to established patients. New-patient status generally means the patient has not received professional services from the physician or qualified practitioner, or another of the same specialty and subspecialty in the group, within the past three years.

Should 99211 be billed when a nurse only gives an injection?

No. If the encounter consists solely of a therapeutic injection, report the applicable administration code, such as 96372, and a drug code when separately reportable. The injection alone does not support an additional 99211.

Does 99211 use medical decision making or time for level selection?

No. Unlike 99212 through 99215, 99211 has no medical decision-making level or minimum practitioner time requirement. Document the distinct, medically necessary E/M service.

What documentation supports a clinical-staff visit under 99211?

Record the reason for the visit, relevant measurements or findings, assessment or instructions, and how the service relates to the treating practitioner's plan. Identify the staff member and supervising practitioner, and document any practitioner communication that occurred.

Can a physician report 99211 for their own visit?

Yes. A physician or qualified health care professional may personally provide the service. Select 99212 or higher only when the documented medical decision making or practitioner time supports that level.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 99211PPRRVU2026_Oct_nonQPP.csv, line 13,013 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet