$302.30
99291 reports the primary critical care service; 99292 reports qualifying additional critical care time and must be paired with 99291.
On this page
CMS RVU26D · Effective 2026-10-01
99292 Critical care Medicare reimbursement rates in Minnesota
Report 99292 with 99291 when a physician or qualified health care professional provides enough additional critical care time for a critically ill patient. Compare 99292 office and facility rates across CMS payment localities in Minnesota.
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 99292 in Minnesota?
Minnesota 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
$130.01
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$95.30
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
Critical care
About 99292: Additional critical care time
Report 99292 with 99291 when a physician or qualified health care professional provides enough additional critical care time for a critically ill patient.
Code 99292 represents additional time spent managing a critically ill or injured patient whose condition creates a high risk of imminent, life-threatening deterioration. A physician or qualified health care professional may provide this care in settings such as an intensive care unit or emergency department; the patient’s acuity and the services furnished, not the unit’s name, support critical care. The work involves focused assessment and management of life-threatening organ-system problems, rather than routine monitoring or a high-complexity visit alone.
Report 99292 only with 99291, when documented critical care time meets the threshold for an additional unit: generally 75–104 minutes total for one unit, with another unit for each additional qualifying interval. Document the patient’s critical condition, the critical care services, and the total time for the date, excluding time spent on separately reportable procedures. CMS treats 99292 as an add-on code billed with a primary service and paid within that service’s global period.
CMS billing rules for 99292
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU2.25 · 56%
- Practice expense (office) RVU1.53 · 38%
- Malpractice RVU0.23 · 6%
406K
Medicare services in 2024 · #253 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.
99292 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
99285 is an emergency department evaluation code. Use 99292 only as additional time with 99291 when the patient’s condition and services meet critical care criteria.
No office rate
99223 describes an initial hospital or observation evaluation. 99292 is reserved for additional time in a critical care service, not a high-level admission evaluation.
Compare 99292 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
Minnesota →
Office / nonfacility
$130.01
Facility
$95.30
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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 99292 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
13,044
- Code
- 99292
- Physician work
- 2.25
- Practice expense
- 1.53
- Malpractice
- 0.23
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.25 | × 1.000 | 2.2500 |
| Practice expense | 1.53 | × 1.029 | 1.5744 |
| Malpractice | 0.23 | × 0.296 | 0.0681 |
| Total RVUs | 3.8925 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$130.01
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1 |
| Practice expense | 1.53 | 1.029 |
| Malpractice | 0.23 | 0.296 |
(2.25 × 1 + 1.53 × 1.029 + 0.23 × 0.296) × $33.4009 = $130.01
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1 |
| Practice expense | 0.52 | 1.029 |
| Malpractice | 0.23 | 0.296 |
(2.25 × 1 + 0.52 × 1.029 + 0.23 × 0.296) × $33.4009 = $95.30
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.
99292 billing questions
When is 99292 reported with 99291?
Report 99292 for qualifying critical care time beyond the time represented by 99291. One unit generally applies at 75–104 total minutes; additional units require additional qualifying time.
Can 99292 be billed by itself?
No. It is an add-on code and must be reported with 99291 as the primary critical care service.
Does the patient have to be in an ICU?
No. Critical care may be furnished in an emergency department or another setting; the patient’s life-threatening condition and the services provided support the code.
What time should the record support?
Document total critical care time for the date, the patient’s critical condition, and the management performed. Do not include time spent on separately reportable procedures.
How is 99292 different from a high-level emergency visit?
99292 is additional time for critical care reported with 99291. A high-level emergency department evaluation code describes an ED visit that does not meet critical care criteria.
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.
13,04199285,,Emergency dept visit hi mdm,A,,4.00,0.65,NA,0.65,,0.48,5.13,5.13,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04299288,,Direct advanced life support,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04399291,,Critical care first hour,A,,4.50,4.29,,1.00,,0.46,9.25,5.96,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04499292,,Critical care addl 30 min,A,,2.25,1.53,,0.52,,0.23,4.01,3.00,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04599304,,1st nf care sf/low mdm 25,A,,1.50,0.84,,0.54,,0.09,2.43,2.13,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04699305,,1st nf care moderate mdm 35,A,,2.50,1.54,,0.91,,0.18,4.22,3.59,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04799306,,1st nf care high mdm 50,A,,3.50,2.05,,1.16,,0.23,5.78,4.89,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002