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CMS RVU26D · Effective 2026-10-01

99222 Initial hospital visit Medicare reimbursement rates in Alaska

Report initial inpatient or observation care when a physician or qualified practitioner performs the first hospital evaluation at moderate MDM or at least 55 minutes. Compare 99222 office and facility rates across CMS payment localities in Alaska.

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.

What does Medicare pay for 99222 in Alaska?

Alaska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$158.33

1 of 1 localities have a supported rate.

Payment area: Alaska*

One mapped payment locality.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 99222 in your payment locality →

Evaluation and management

About 99222: Initial inpatient or observation care, moderate complexity

Report initial inpatient or observation care when a physician or qualified practitioner performs the first hospital evaluation at moderate MDM or at least 55 minutes.

This service is the first hospital evaluation by a physician or qualified practitioner during an inpatient admission or observation stay. A hospitalist or admitting physician may assess a patient hospitalized for pneumonia, a COPD exacerbation, or worsening heart failure; a specialist may also use the initial hospital care family for a first evaluation during the stay. The diagnosis alone does not establish the level. The clinician’s assessment, review of available records and results, treatment decisions, and communication with other clinicians help establish the work performed.

Select 99222 for moderate medical decision making (MDM) or at least 55 minutes of the billing practitioner’s total time on the encounter date. Document the problems addressed, data considered, and management risk when selecting by MDM, or document total time when selecting by time. An initial hospital care service is generally reported once per admission by a physician or practitioners of the same specialty in the same group. For Medicare, the principal physician of record identifies the admission service with modifier AI; other physicians reporting initial hospital care omit it. If admission and discharge occur on the same date, Medicare uses a combined service code when the stay lasts at least eight hours.

Where the value comes from

  • Work RVU2.60 · 74%
  • Practice expense (office) RVU0.67 · 19%
  • Malpractice RVU0.23 · 7%

6M

Medicare services in 2024 · #36 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.

99222 compared with similar codes

Office rates for Alaska, from the same CMS release.

99221

Initial hospital care

Straightforward or low MDM, 40 minutes

No office rate

Both describe initial inpatient or observation care. Choose 99221 for straightforward or low MDM, or 40 through 54 minutes when selecting by time; 99222 requires moderate MDM or at least 55 minutes.

99232

Subsequent hospital visit

Moderate MDM or 35 minutes

No office rate

99222 is an initial hospital evaluation by the practitioner; 99232 is a subsequent inpatient or observation visit supported by moderate MDM or its applicable time minimum.

99235

Hospital care

Same-day, moderate complexity

No office rate

For Medicare, choose 99235 for moderate-level admission and discharge care on the same date when the stay lasts at least eight hours. A shorter same-date stay may support 99222 without a separate discharge code.

99204

Office visit

New patient, moderate complexity

$222.54

99204 is a new-patient office or outpatient E/M visit. Use the initial hospital care family for an inpatient admission or observation evaluation.

Compare 99222 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

  • Alaska* →

    Office / nonfacility

    Unavailable

    Facility

    $158.33

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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 99222 in Alaska*.

PPRRVU2026_Oct_nonQPP.csv

13,019

Code
99222
Physician work
2.60
Practice expense
0.67
Malpractice
0.23

GPCI2026.csv

5

Locality
Alaska*
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Facility calculation for 99222 in Alaska*
ComponentRVULocality factorAdjusted
Physician work2.60× 1.5003.9000
Practice expense0.67× 1.0650.7136
Malpractice0.23× 0.5510.1267
Total RVUs4.7403
Conversion factor× 33.4009

Facility rate, Alaska*$158.33

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.61.5
Practice expense0.671.065
Malpractice0.230.551

(2.6 × 1.5 + 0.67 × 1.065 + 0.23 × 0.551) × $33.4009 = $158.33

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.

99222 billing questions

How is 99222 chosen over 99221 or 99223?

Choose 99222 for moderate MDM or at least 55 minutes of practitioner time. If selecting by time, 40 through 54 minutes supports 99221, while 75 minutes or more supports 99223; select the highest level supported by MDM or time.

Can 99222 be used for observation patients?

Yes. The initial hospital care family covers both inpatient admissions and observation stays; select 99222 when moderate MDM or the 55-minute minimum is met.

What if admission and discharge occur on the same calendar date?

For Medicare, report the appropriate combined admission-and-discharge code from 99234–99236 when the stay lasts at least eight hours. For a shorter same-date stay, report the supported initial hospital care code without a separate discharge service.

Who appends modifier AI to 99222?

For Medicare, the principal physician of record appends AI to identify the admission service. Other physicians reporting their first hospital evaluation use the supported initial hospital care code without AI.

Is an ED or office visit on the admission date billed separately?

When the admitting physician performs an office or ED evaluation before admitting the patient that day, Medicare includes that work in the hospital admission E/M service rather than paying a separate E/M visit.

What counts toward the 55 minutes?

Count the billing practitioner’s face-to-face and qualifying non-face-to-face work on the encounter date, such as reviewing records, documenting, ordering tests, and coordinating care. Exclude time spent on separately reported services.

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 99222PPRRVU2026_Oct_nonQPP.csv, line 13,019 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet