CPT code 99236: Hospital care2026 Medicare rate & RVUs in Alaska
Report this service for high-complexity hospital inpatient or observation care when the patient is admitted and discharged on the same date.
CMS doesn’t publish an office rate for 99236 in Alaska.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 99236 covers
This service covers a high-complexity evaluation and management encounter in which a physician or other qualified health care professional admits a patient to inpatient or observation care and discharges the patient on that same calendar date. It may be used in a hospital setting when the patient’s condition and care needs warrant a high level of decision making, such as a serious acute presentation requiring substantial evaluation and management before safe discharge.
Choose this level when medical decision making is high or, when selecting by time, the reporting professional’s total time on the date meets or exceeds 85 minutes. The record should establish the admission and discharge dates and support the selected level through the medical decision-making elements or a time statement. Report one combined same-date service rather than separate admission and discharge E/M services. Medicare values the service through the physician fee schedule; the CMS facts supplied for this code list no additional payment rules.
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.
99236 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $258.34 |
How the 99236 rate is calculated
Each of 99236’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 · 99236
RVUs × geographic indexes × conversion factor
Work4.30
4.30 RVUs× 1.000 GPCI
Practice expense1.02
1.02 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
5.6800
Conversion factor
$33.4009
Medicare rate
$189.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99236
99236 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 · 99236
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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99236 isn’t priced in this setting.
99236 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99235Hospital care
- Both cover same-date hospital admission and discharge; 99235 represents moderate rather than high medical decision making, or its corresponding time-based level.
- 99223Initial hospital visit
- Use 99223 for initial hospital care when the patient is not admitted and discharged on the same date; 99236 combines those same-date services.
- 99238Hospital discharge
- 99238 is discharge management for a discharge on a later date, rather than a same-date admission-and-discharge encounter.
99236 billing questions
When should 99236 be selected instead of 99235?
Use 99236 for same-date admission and discharge when medical decision making is high or total time meets or exceeds 85 minutes. Use 99235 when the supported level is moderate or time meets its applicable threshold.
Can admission and discharge be billed as separate E/M services on the same date?
No. This code represents the combined hospital inpatient or observation admission and discharge service when both occur on the same date.
Can time determine the level?
Yes. The physician’s or qualified health care professional’s total time on the date must meet or exceed 85 minutes. Document the time used to select the service.
What documentation supports 99236?
Document the same-date admission and discharge, the medically appropriate evaluation, and either high-level medical decision making or total time meeting the threshold.
Should 99236 be reported when the patient remains hospitalized after the admission date?
No. For an admission without discharge on that date, select the applicable initial hospital care service; subsequent hospital care applies on later dates.
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
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