No office rate
99471 covers the initial 24-hour period of pediatric critical care for children aged 29 days through 24 months; 99472 is for subsequent days.
On this page
CMS RVU26D · Effective 2026-10-01
99472 Pediatric critical care Medicare reimbursement rates in Arkansas
Report 99472 for a subsequent day of critical care management for a critically ill infant or young child aged 29 days through 24 months. Compare 99472 office and facility rates across CMS payment localities in Arkansas.
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 99472 in Arkansas?
Arkansas 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
$333.09
1 of 1 localities have a supported rate.
Payment area: Arkansas
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.
Pediatric critical care
About 99472: Subsequent critical care for infant
Report 99472 for a subsequent day of critical care management for a critically ill infant or young child aged 29 days through 24 months.
Code 99472 represents a subsequent day of critical care for a critically ill child aged 29 days through 24 months. Pediatric intensivists, hospitalists, and other physicians may provide this care in an ICU or another setting equipped to manage an immediately threatening condition. Examples include acute respiratory failure, septic shock, or severe cardiac instability when the child needs high-complexity decisions to prevent or manage deterioration in a vital organ system.
Select 99472 for a subsequent day, not the initial 24-hour period; use 99471 for that initial period. The record should support the child’s age, critical illness, threatened organ function, and the physician’s high-complexity management on the billed day. This is a daily service, not a code selected by adding up minutes. Routine assessment and management integral to that day’s critical care are part of the service rather than a separate E/M service for the same work.
Where the value comes from
- Work RVU7.99 · 76%
- Practice expense (office) RVU1.96 · 19%
- Malpractice RVU0.58 · 6%
206
Medicare services in 2024 · #4305 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.
99472 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
99469 is the subsequent-day neonatal critical care code. Choose based on the patient’s age group, not simply the similarity of the critical-care service.
No office rate
99476 covers subsequent-day pediatric critical care for children ages 2 through 5 years; 99472 covers ages 29 days through 24 months.
Compare 99472 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
Arkansas →
Office / nonfacility
Unavailable
Facility
$333.09
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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 99472 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
13,139
- Code
- 99472
- Physician work
- 7.99
- Practice expense
- 1.96
- Malpractice
- 0.58
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.99 | × 1.000 | 7.9900 |
| Practice expense | 1.96 | × 0.859 | 1.6836 |
| Malpractice | 0.58 | × 0.515 | 0.2987 |
| Total RVUs | 9.9723 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$333.09
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.99 | 1 |
| Practice expense | 1.96 | 0.859 |
| Malpractice | 0.58 | 0.515 |
(7.99 × 1 + 1.96 × 0.859 + 0.58 × 0.515) × $33.4009 = $333.09
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.
99472 billing questions
When should 99472 be used instead of 99471?
Use 99471 for the initial 24-hour period of pediatric critical care in this age group. Use 99472 for each subsequent day of qualifying critical care.
Does the child have to be in an ICU?
No. The setting alone does not determine code selection; the child must meet the critical-care criteria and receive the required high-complexity management.
Is 99472 based on a number of minutes?
No. It represents a subsequent day of care, rather than a timed increment. Document the critical-care service provided on that day.
Can routine inpatient follow-up be reported as 99472?
No. The child must remain critically ill and require critical-care management; routine daily hospital care alone does not support this code.
What documentation supports 99472?
Document the child’s age, the critical condition and threatened organ function, and the high-complexity assessment and management performed on the subsequent day.
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.
13,13699469,,Neonate crit care subsq,A,,7.99,1.61,NA,1.61,,0.48,10.08,10.08,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13799470,,Rpm tx mgmt 1st 10 min,A,,0.31,0.45,,0.07,,0.02,0.78,0.40,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13899471,,Ped critical care initial,A,,15.98,3.22,NA,3.22,,0.99,20.19,20.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,13999472,,Ped critical care subsq,A,,7.99,1.96,NA,1.96,,0.58,10.53,10.53,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14099473,,Self-meas bp pt educaj/train,A,,0.00,0.45,,0.45,NA,0.01,0.46,0.46,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14199474,,Self-meas bp 2 readg bid 30d,A,,0.18,0.36,,0.05,,0.01,0.55,0.24,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,14299475,,Ped crit care age 2-5 init,A,,11.25,2.26,NA,2.26,,0.68,14.19,14.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541